Your employment status shouldn’t stand in the way of life-saving treatment.
If you find yourself uninsured due to job changes, it’s important to find ways to continue your HIV treatment without insurance. “HIV is one of those diseases that doesn't care if you have health insurance or not. It needs to be treated—every month,” says Stella Safo, MD, HIV internist at Icahn School of Mount Sinai.
Sticking to your HIV treatments as prescribed is critical. It helps ensure that your viral load doesn’t increase, causing the infection to progress. However, many who are at risk of contracting HIV or developing AIDS are equally at risk of poverty or unemployment. This includes trans women, people who inject drugs, or those who have been living with the illness and paying for treatment long-term.
Free or Affordable HIV Treatment Alternatives for Patients Without Health Insurance
Health insurance disruption is one of the most common challenges for HIV treatment. If you lose your job or change your health insurance, there’s a chance that available insurance plans no longer cover your medications or doctor visits. Your doctor may no longer be “in-network,” which may require you to start over with another HIV doctor.
You might think that if you lose your insurance, you have no way to afford or continue your treatment regimen. This is not the case. If you have a sudden break in your health insurance, it's really important to speak with your doctor or clinic’s social worker. They can actually connect you with local public health programs to get free HIV medication.
How’s this possible? HIV is a matter of public health, so it's in your community’s best interest to make sure you’re able to continue HIV treatment without insurance. That’s because when your viral load stays low, you have a much lower risk of transmitting HIV to others. Everyone wins when people with HIV have consistent and affordable access to their medication.
Here are some options to continue treatment if you lose or change your health insurance:
- The Affordable Care Act (ACA) mandates that plans can’t drop you or deny coverage based on pre-existing health conditions like HIV. Also, insurers can’t impose lifetime caps on insurance benefits.
- Medicaid is a government program that provides free or low-cost health insurance to certain people. This includes low-income individuals or families, people with disabilities, people who are pregnant, older adults, and more.
- COBRA is a program that provides health insurance for a short period of time from your previous employer. This way, you can retain your health insurance from your job even after you’ve lost your employment.
- The Veterans Administration (VA) is the largest single provider of medical care to people living with HIV in the U.S., supporting over 24,000 veterans living with HIV.
- Patient Assistance Programs (PAPs) are administered by pharmaceutical companies to offer free or reduced-cost antiretroviral (ARV) therapy to low-income people living with HIV who are un- or underinsured (but don’t qualify Medicaid, Medicare, or AIDS Drug Assistance Programs)
- American Indian and Alaska Native Programs like the Indian Health Service (IHS) provide health care services—including HIV services—for members and descendants of federally recognized American Indian and Alaska Native Tribes.
- The Ryan White HIV/AIDS Program, which works with cities, states, and local community-based organizations to provide HIV-related services to more than half a million people each year without sufficient coverage
- State or local programs are available around the country and help you continue your HIV treatment without insurance. Your doctor or social worker can connect you to these programs.
Disclosing Your Status At Work to Get the Coverage You Need
You do not need to share your HIV status at work in order to get the appropriate health insurance. HIV diagnosis is protected. This means that no one is entitled to know about it unless you choose to disclose it.
If you’re starting a new job, just remember that you are not required to disclose your HIV diagnosis if you fear discrimination. All you have to do is say you need the insurance—and nothing else.
The most important thing to remember is that you never have to discontinue your treatment due to losing your insurance. There are a number of people and programs that can help.
Stella A. Safo, MD, is an HIV primary care physician and assistant professor of Medicine at the Icahn School of Medicine at Mount Sinai Hospital.