Insurance can be confusing. We want every person living with HIV to know that insurance and cost of medical care should not stop you from seeing the doctor and receiving medication. There are endless amounts of resources to help make medical care affordable. We are here to help you figure out what is best for you.
A few basics:
Ryan White - Ryan White is the nation’s safety net for people living with HIV. It covers the cost of HIV medical care (doctor’s visits and labs) and treatment (medication co-pays) for those without health insurance, it can also assist when insurance does not cover the full cost. Many community organizations and doctor’s offices in Detroit have Ryan White services and can help you get medical care. If you want to be connected to once of these agencies, fill out this confidential form and we will connect you as soon as possible.
MIDAP - Michigan Drug Assistance Program (MIDAP) is a Ryan White program that specifically covers the cost of health insurance and/or medication for people living with HIV. MIDAP can be useful for all of your medical needs - not just HIV.
Michigan Health Care Information - Information about the latest Michigan health care options and links to applications for programs such as:
Medicaid - Various insurance plans to cover low-income adults plus children and pregnant women
Healthy Michigan Plan - For people age 19-64 years, with an income at or below 133% of the federal poverty level ($16,000 for a single person or $33,000 for a family of four). You apply for Medicaid on:
MIBridges - Online system to enroll in multiple benefit programs - healthcare coverage, cash assistance, State Emergency relief (SER), child development and care, food assistance program
By phone - 844-464-3447
MI Health Link - MI Health Link is a new health care option for Michigan adults, ages 21 or over, who are enrolled in both Medicare and Medicaid, and live in the counties of Barry, Berrien, Branch, Calhoun, Cass, Kalamazoo, Macomb, St. Joseph, Van Buren, Wayne or any county in the Upper Peninsula.
Affordable Care Act (often referred to as ACA or ‘Obama care’) - For people aged 18 - 64 with an income of 133% - 400% of the federal poverty level (roughly $16,000 - $49,500 for a single adult). With an income in this range, you will qualify for cheaper health care coverage. MIDAP can also help people living with HIV pay some of the monthly insurance costs (premiums).
Enrollment period is Nov 1 - Dec 15 each year. For example, to enroll in a 2020 health insurance plan, you would need to enroll during Nov 1 - Dec 15, 2019. You can qualify for a special enrollment period if you have a major life event during the year - major life event include things like losing your job, marriage, divorce, birth of a child, etc.
Medicare - For people 65 years or older OR under 65 with certain disabilities. Most people need to enroll in medicare when they turn 65. Medicare enrollment begins three months before your 65th birthday and continues for 7 months. If you are currently receiving Social Security benefits, you don't need to do anything. You will be automatically enrolled in Medicare Parts A and B effective the month you turn 65. ACE TA Resources
Employer-sponsored health coverage - You may qualify for health insurance from your employer. You should be able to talk with the insurance company directly to ensure they cover your HIV medical costs. You do NOT have to discuss your personal health information or HIV status with anyone at your job, including Human Resources.
What do all those different insurance words mean? Premium, co-pay, deductible, etc.
Want to learn more?
Helpful webinars and tools:
ACE TA Center - Several helpful resources and online videos to help you better understand insurance options for people living with HIV
Start here: Basics of Health Coverage Enrollment (Aug 2019)
MIDAP Medicare Open Enrollment Webinar (Oct 2019)
Note on Medicaid Work Requirements: People living with HIV are EXEMPT from work requirements - this means they are not required to work or pay part of their monthly insurance costs (otherwise known as premiums). To make sure Medicaid has you listed as exempt, call the Beneficiary helpline at 1-888-367-6557 (you'll need DOB and social security #) or logon to MIBridges.