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Ryan White Coverage and Eligibility

HIV/AIDS Comprehensive Care Program Contact Information

(608) 263-0946

 

Related Resources

Ryan White Funding

Who Was Ryan White?

The UW Health HIV/AIDS Comprehensive Care Program is committed to providing care to people living with HIV, regardless of ability to pay. For those who are uninsured or underinsured, the Ryan White Program provides financial assistance with medical and non-medical services. Note: you do not have to be eligible for Ryan White coverage to receive care at the UWHIV clinic.

 

Am I eligible for the Ryan White Program?

 

You are eligible for Ryan White coverage if you:

  • Are HIV positive
  • Have an income under 500% Federal Poverty Level (in 2018: $60,700 annually for a 1 person household; $82,300 for a 2-person household, and so on)
  • Are a Wisconsin resident
  • Do not have health insurance or have insurance and are responsible for out of pocket costs, including medication copays or coinsurance for office visits

How do I get coverage?

  • A clinic medical case manager will enroll you in the Ryan White Program if you are eligible. Ryan White is the payor of last resort, which means we will provide assistance with enrollment in other insurance options if possible.  
  • If you ever lose or have a lapse in your health insurance, please call (608) 263-0946 immediately for assistance in obtaining other coverage. This is very important so you can continue to see your doctor, and get your medications.

What does Ryan White cover?

 

The Ryan White Program covers the costs of medical care and supports services for both uninsured and insured eligible individuals. If you are uninsured, the Ryan White Program will cover the primary charge for the service and you may be responsible for a small copay. If you are insured, the Ryan White Program will provide assistance with your copays, coinsurance and deductibles and you will be responsible for a small copay.

 

Will I pay anything if I'm enrolled in Ryan White?

  • You may be responsible for a small copay based on your income: see the fee scale (pdf)
  • Please call us to update your income if it changes, so your copay amount is correct
  • Please review the fee scale by clicking the link to the printer friendly version in the upper right of this page
  • We do not send these bills to collections

Questions?

 

Please call clinic medical case managers at (608) 263-0946.


Coverage

 

Medical Services Within HIV Clinic Ordered by HIV Provider:

  • HIV clinic visits with HIV medical provider
  • Labs: CD4 count and viral load, resistance testing; Other diagnostic labs, tests, procedures or imaging ordered by HIV medical provider (including ultrasounds, CT scans, MRIs, lung function tests, bone mineral density scans).
  • Cervical cancer screening: annual cervical pap smear in HIV clinic and referrals to Gynecology for follow-up for abnormal cervical paps, including repeat cervical paps, colposcopies, and biopsies (cervical cancer treatment not covered)
  • Anal cancer screening (anal cancer treatment not covered):
    • Annual anal pap done in HIV clinic
    • Referrals to colorectal surgery clinic for anoscopy/biopsy needed for follow-up of abnormal pap
    • Referrals to surgeon for consultation on Condyloma
  • Screening and treatment for tuberculosis (TB)
  • Screening and treatment for Hepatitis B and C
  • Screening and treatment for sexually transmitted infections (STIs)
  • Routine immunizations administered in HIV Clinic
  • Primary care provided in HIV Clinic
  • Urgent care provided in HIV Clinic
  • Smoking cessation treatment

Other Services Within the HIV Clinic:

  • Medical case management provided by HIV clinical social workers
  • Clinical pharmacy consultation provided in ID clinic
  • Mental health screening and referral for treatment
  • Addiction screening and treatment
  • Male and female condoms and lubricant

Medications:

  • Antiretrovirals and other HIV related outpatient medications (primarily covered by ADAP program)
  • Other outpatient medications, not covered by ADAP:
    • Other outpatient medications prescribed by HIV provider, primary care provider, or psychiatric/addiction medicine provider filled at UW Health Pharmacy. 

Services Outside of the UWHIV Clinic:  

  • Psychiatric treatment provided by a UW Health psychiatrist
  • Psychiatric treatment and groups provided by Journey Mental Health Center (JMHC)
  • Covered if referral by HIV provider and scheduled by HIV social worker in designated clinic at JMHC
  • Medications filled at UW Health Pharmacy
  • Colorectal surgery visits for anoscopy and/or biopsy related to the follow-up of an abnormal anal pap result
  • General surgery visits related to the follow-up of an abnormal anal pap result, abnormal anoscopy, or condyloma
  • Dermatology visits related to the follow-up of HIV-related conditions or condyloma
  • Gynecology visits for follow-up of an abnormal cervical pap result, including repeat cervical paps, colposcopies, and biopsies
  • Nutrition clinic visits referred by HIV medical provider
  • Ophthalmology visits for retinal exams
  • Dental care is available at the Beloit Area Community Health Center or ARCW Dental Clinic

Non-Covered Services:

  • In-patient care hospital (referral to UW Health Community Care program)
  • Emergency department care
  • Care that is not HIV- or HIV-treatment related