Looking to start meds soon and am moving to Europe.

[rick21007]

Have an appt with my hiv MD on the 26th and we will be discussing my starting meds.  I am also planning to move to Europe--to Bucharest initially and then either we will be moving to Paris in the spring or coming back to the states.  I understand that meds are cheaper in Europe.  I will be losing my insurance when I move.  Any one knowledgeable about medication resources that would be available to non-citizens, is there are any?  This would be one of the deciding factors as far as moving to France vs. coming back to the states.  Also anyhone know what meds are covered by patient assistance programs?  Maybe I am dreaming that there is anything available at all but I thought I would ask.

Rick

[blondbeauty]

I don´t know how this works in Romania. But it is a very poor country. On the other hand, the French National Health System is one of the best in the world.
I can tell you how it is here in Spain, but I am sure it works in similar way in France. Once you are established in France, you must register in your city townhall. You will receive a sanitary card (like a credit card) and you can start using the National Health System. Meds in most of the EU countries are free.
Here is a link about how to obtain the National Health System in Spain. I am sure in France is easyer and better.
Who Has The  Riight?
Medical assistance is the benefit of medical and pharmaceutical services necessary to conserve or to restore the health of the protected people.
 General With general character, they will have right all the foreign, Spaniards and citizens whom they have established its residence in the national territory. Foreigners If they are enrolled in the municipal register in which they reside habitually, they have right to the medical assistance in the same conditions that the Spanish citizens.
Foreign minors under 18 years of age,  even when they do not have established their residence in Spain legally and are not included inside a familiar unit.
The pregnant foreigners will have right to medical assistance during the pregnancy, childbirth and postchildbirth.
 In any case, everybody has the right to receive the Urgent Medical Assistance.
This is the link to all the National Health Services in Madrid (Spain) I am sorry there is no english website.
http://www.madrid.org/cs/Satellite?pestanna=1&vest=1155886657113&pagename=PortalSalud%2FPage%2FPTSA_subhome&language=es&cid=1155886657113

[rick21007]

Thankyou for the information.  It is helpful and encouraging.  Soy leo Espanol.

Rick

[Cerrid]

As blondie said, despite of their recent entry into the E.U., Romania is a poor country. The health system lacks doctors, funds, equipment and certain meds. You should definitely check beforehand what will be available to you before you start meds otherwise you may have to switch your combo when you're there. It's a totally different situation than in the western European countries.

[livingpos]

Hi,

I find myself in a similar situation. I want to move to Europe in May 2008, am not currently on meds. Since I am intending on staying 2 years on a teaching contract, I would have to apply for residence permit /worl permit. I have been sorting through which countries have restrictions and there is a lot of conflicting information. For example I would love to go to Spain but several websites say that a foreigner has to submit an HIV- status to qualify for residence, France and Germany too. I got this info from the US state dept website.

any additional info would be great
JOnathan

[blondbeauty]

I am Spanish. There are no such restrictions to become a resident in Spain. If you come with a contract there is no problem. And even if you where illegal you just have to register yourself. We call it "empadronarse" which consists in giving a permanent adress. You will receive your health card and you may start using the National Health System. Every Autonomic Comunity recieves fundings from the central government depending on the number of people that are registered in each community. So it is important to keep it updated at all times.
This is the card you will recieve:
http://www.madrid.org/cs/Satellite?pageid=1156329829769&vest=1156329829769&pagename=PortalSalud%2FPTSA_Generico_FA%2FPTSA_pintarGenerico&language=es&cid=1142329323358
You can also ask for a European Health Card: http://www.madrid.org/cs/Satellite?pageid=1156329829769&vest=1156329829769&pagename=PortalSalud%2FPTSA_Generico_FA%2FPTSA_pintarGenerico&language=es&cid=1159882061459
On this website you will find all you need to know about the Public Health System in Madrid, hospitals, etc.
http://www.madrid.org/cs/Satellite?pestanna=1&pagename=PortalSalud%2FPage%2FPTSA_subhome&language=es&cid=1155886657113
Be prepared to wait one month for the first appointment. Remember HIV is not treated by private doctors or by private insurance companies. HIV meds are not available at regular pharmacies and you can not buy them. The best hospital in Madrid for the treatment of HIV is "Carlos III". You will be a asigned a general practitioner and he will send you to the hospital of your area to diagnose your HIV infection and start the follow up and treatment. Remember few people speak English in Spain, so you will need the help of a person you trust.
Link to the "carlos III" hiv unit in English: http://www.fundacionies.com/personal.php?lang=ing
Moreover, I found this secction on the same website about the strategy to fight against HIV:
http://www.madrid.org/cs/Satellite?vest=1156329913935&pagename=PortalSalud%2FPage%2FPTSA_pintarContenidoFinal&language=es&cid=1156329913935
This is a subsection about the medical atention for HIV+ people: http://www.madrid.org/cs/Satellite?idNivel4=1142331654978&vest=1156329913935&pagename=PortalSalud%2FPage%2FPTSA_pintarContenidoFinal&language=es&cid=1142331367639
And about the 3 types of pharmaceutical attention and coverage:http://www.madrid.org/cs/Satellite?vest=1156329829805&pagename=PortalSalud%2FPage%2FPTSA_pintarContenidoFinal&language=es&cid=1156329829805

[northernguy]

Bucharest?  Interesting choice, I'm sure there's a story.   Best of luck in Europe, from what others have posted, it sounds welcoming from a medical standpoint.

[livingpos]

Northernguy, thanks for all of the very useful information, I have been very pleasantly surprised by the email responses I got from offices of European consular affairs. While several websites list countries as having restrictions since 2003 much of this information is incorrect. The EU has a blanket statement that non-EU citizens applying for work permits / residence must be HIV- but it seems many governments are not adhering to this policy. Good for them! And good for us! I was quite touched by the tone in many of the email replies, people were genuinely offended that someone with HIV would be treated differently or denied entrance to their country. Obviously there are exceptions, but for the most part the news is tremendously encouraging.

thanks again
Jonathan

[vokz]

A note of caution about the information given on the US State Department website: They generally tell you what rights individual governments reserve for themselves; which, in the case of EU countries, is very rarely the rules that are generally applied.

EU countries do not routinely ask whether you are HIV-positive (nor require you to submit to an HIV test), but all reserve the right to – and when they do exercise that right, it is generally only because they have a reason to suspect that you are unwell AND that you are travelling from a resource limited setting for the SOLE purpose of getting free / subsidised healthcare.

Some of the newer EU states are more prone to exercise their rights, because the EU country that grants a non-EU citizen access / residency rights then assumes certain legal responsibilities for that person if they then start taking advantage of the lack of border controls to move around within the EU.

If you have a firm offer of a job, you are unlikely to be subjected to particular scrutiny / questioning – and even if you are, then a firm verifiable offer of a job, from a reputable organisation, will mean that you are unlikely to be refused. The fact that you are arriving from the USA makes it even less likely that you will be subjected to scrutiny, because it isn’t one of the countries of origin that would generally arouse suspicions of health tourism.

Once granted a residency / work permit in any EU country, you will - as a general rule - have exactly the same access to the healthcare systems of that country as a citizen would (and, subject to getting the correct paperwork from the EU country of which you are a resident, also access to emergency healthcare in any EU country you may choose to visit for recreational purposes).

I can only assume that the State Department does what they do in order to make their own inflexible rules on HIV look less odious than they are.

As regards treatment in Romania - it may not be the richest of countries; but, as well as being heavily subsidised by the richer EU countries, they do benefit from significant price reductions from the drug manufacturers and are therefore able to provide the same universal coverage to HIV-positive residents that most other EU countries do.

Translated versions of HIV i-Base’s excellent (IMO) treatment guides are widely used there, so if you read the English version of 'Introduction to Combination Therapy' you will have a pretty good idea of the drug availability and the sort of treatment guidelines in use there. (http://i-base.info/guides/starting/index.html)

[rick21007]

Vokz-----thankyou for your thoughtful and informative reply.  I had heard that meds were much cheaper in Romania.   I have an appt. with my hiv doc in 3 weeks to discuss whether I will be going on meds or not at this time.  I have already found out how the wheels of government _really_ work.

Rick

[John2038]

Hi

please find below your rights as a foreigner in France (translated by Google):

http://translate.google.com/translate?u=http%3A%2F%2Fwww.actupparis.org%2Farticle296.html&langpair=fr%7Cen&hl=fr&ie=UTF-8&oe=UTF-8&prev=%2Flanguage_tools


If you have any questions, ask me, as I speak French.

[vokz]

I had heard that meds were much cheaper in Romania.

My understanding is that they will be free if you get a work permit and are resident there for tax purposes. Check it out to be certain, but I am pretty sure they now have a policy of universal free access to HIV care.

[blondbeauty]

These are the official Spanish Recommendations for the treatment on HIV infection:
http://www.gesida.seimc.org/english/pcientifica/guidelines.asp?apnv0=pcientifica&apnvA=guidelines&appag=guidelines_txt.htm
And this is the document (IN ENGLISH) of the Ministry of Health in wich the Spanish National Health System bases the treatment of HIV infection. But always remember you may start treatment whenever you want. Just as I did. "Alberche" another spanish member in these forums started treatment with a cd4 count close to 1.000.http://www.gesida.seimc.org/pcientifica/fuentes/DcyRc/DcyRc_Recommendations_GESIDA_Spanish%20AIDS_Plan.pdf