Quantcast

Subscribe to:
POZ magazine
E-newsletters
Join POZ: Facebook MySpace Twitter Pinterest
Tumblr Google+ Flickr MySpace
POZ Personals
Sign In / Join
Username:
Password:
Welcome, Guest. Please login or register.
July 28, 2014, 03:42:22 AM

Login with username, password and session length


Members
Stats
  • Total Posts: 632064
  • Total Topics: 47855
  • Online Today: 201
  • Online Ever: 585
  • (January 07, 2014, 02:31:47 PM)
Users Online
Users: 1
Guests: 163
Total: 164

Welcome


Welcome to the POZ/AIDSmeds Community Forums, a round-the-clock discussion area for people with HIV/AIDS, their friends/family/caregivers, and others concerned about HIV/AIDS.  Click on the links below to browse our various forums; scroll down for a glance at the most recent posts; or join in the conversation yourself by registering on the left side of this page.

Privacy Warning:  Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If you are HIV positive and disclose this in our forums, then it is almost the same thing as telling the whole world (or at least the World Wide Web). If this concerns you, then do not use a username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.

  • The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own physician.

  • All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.

  • Forums members must behave at all times with respect and honesty. Posting guidelines, including time-out and banning policies, have been established by the moderators of these forums. Click here for “Am I Infected?” posting guidelines. Click here for posting guidelines pertaining to all other POZ/AIDSmeds community forums.

  • We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are true and correct to their knowledge.

  • Product advertisement—including links; banners; editorial content; and clinical trial, study or survey participation—is strictly prohibited by forums members unless permission has been secured from POZ.

To change forums navigation language settings, click here (members only), Register now

Para cambiar sus preferencias de los foros en español, haz clic aquí (sólo miembros), Regístrate ahora

Finished Reading This? You can collapse this or any other box on this page by clicking the symbol in each box.

Author Topic: How Much Does HIV Cost in Healthcare Plans.  (Read 6369 times)

0 Members and 1 Guest are viewing this topic.

Offline TheRoof

  • Member
  • Posts: 188
How Much Does HIV Cost in Healthcare Plans.
« on: November 03, 2009, 12:38:50 PM »
At the moment I am covered with my family plan. Though I am in college going into finance. In two years I will get my Bachelors Degree in Finance so hopefully I can start making decent money and claim myself as independent.

My question is how much of your income does HIV take. 5%, 25%? Personally which health plans or health care options are probably the best with living with HIV. In your opinion? Basically talking about general health care.

I know for each individual it will be different due to their health. Though if to use the general numbers for The Meds. How would you calculate that. Share your experiences with the health care system.
« Last Edit: November 03, 2009, 12:46:36 PM by TheRoof »

Offline WildcatCC

  • Member
  • Posts: 91
Re: How Much Does HIV Cost in Healthcare Plans.
« Reply #1 on: November 03, 2009, 01:09:35 PM »
As posted before, I'm very lucky to work within a world-class health care organization. My benefits are excellent, especially if I utilize my employer (self insured) as my care giver.

Here is what I've experienced. It may not be typical but may serve as a framework.

When diagnosed with HIV/AIDs (I went right to AIDs - always trying to be an over achiever), it was when I was rushed to the hospital for what turned out to be PCP. 2 weeks in the hospital (1 in ICU), my total bill was slightly over $46,000. Since I was receiving care at my facility (and I humbly believe the best care ever!), my total out-of-pocket expense was $100 which was later reimbursed as I was admitted via the ER.

Since that time, my only other HIV-related expenses have been co-pays for meds and office co-pays for my ID doc. Here is the breakdown:

MEDS

Initial Regimen - $600 every 90 days x 4 times a year = $2400 (2008)
New Regiimen - $250 every 90 days x 4 times a year = $1000 (2009)

Androgel - $500 (2 months but then switched to testosterone shots which are an office procedure not a drug cost)

OFFICE

Co-pays $250 ($20 every 8 weeks for a year plus $20x 6 for 6 testosterone procedures)

I hope this info helps.
Mark
 
Apr  08 - Diagnosed
Apr  08  cd4 8, vl 150k
Meds: Prezista/Norvir/Truvada
June 08 cd4 250, vl 1600
Aug  08 cd4 275, vl 450
Meds: Atripla
Nov  08  cd4  386, vl 255
Jan   09  cd4  415, vl 2100 (spike?)
Feb   09  cd4 460, vl 212
May   09  cd4 515, vl 1200
Aug   09  cd4 717, vl 1535 % 23
Sept  09  cd4 535  vl 1710 % 18
Oct   09  genotype shows mutation. Discussing w/ ID Doc
Nov  09   cd4 480  vl 650   % 19
Dec  09 genotype slight mutation to Epivir and Retrovir
Jan 10   cd4 508 vl 250 (21%)  low vitamin d - on supplement 2000 iu/day
Mar 15 Change to Isentress and Truvada
May 5 cd4 498 vl 1485
June 16 cd4 550 vl undect!!!! (finally dammit)

Offline Assurbanipal

  • Member
  • Posts: 2,173
  • Taking a forums break, still see PM's
Re: How Much Does HIV Cost in Healthcare Plans.
« Reply #2 on: November 03, 2009, 01:31:08 PM »
With a degree in finance plan to go to work for a large company with a good health plan.  Most of them will be glad to talk about their benefit programs and give you a link to them if you ask.

Predicting how much you will be asked to pay for a health plan two years from now while we are in the middle of passing a huge change in the laws governing health insurance may not be very productive.
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline justaguy

  • Member
  • Posts: 83
Re: How Much Does HIV Cost in Healthcare Plans.
« Reply #3 on: November 03, 2009, 01:38:36 PM »
I've only been diagnosed for about 7 months..but with the same employer/health insurance plan for 5 years or more.  My biggest fear was that my group insurance would drop me, but i guess that's not likely to happen....that's why it's GROUP insurance.  I'm in it for about $1,000 so far.  I was diagnosed with AIDS, though I had no opportunistic infection, just a low CD4...no hospital stays now (or ever hopefully).  There was $685 for genotype testing which I had to pay out of pocket towards my deductible.  My labs are free as long as I use the insurance company's preferred lab.  Then $45 a month for the Atripla copay, which is a drop in the bucket compared to the $1800 the receipt shows.  Add in $20 per doctor visit copay.  I'm estimating I"ve been to the doctor about 6 or 7 times since diagnosis, plus therapy sessions :0).  Of course, your mileage may vary.  As someone who hardly ever even used their health insurance before, I'm getting a real education.  I've been saving all my receipts - I think some of it can be deductible, but only if it adds up to a certain percentage of your income.  Again, it's time for me to do more research.  
Estimated infection: 3/2008
Tested HIV positive: 3/31/2009
CD4 136/unknown %/VL 150,000: 4/6/2009
Started Atripla 4/17/2009
CD4 255/19%/VL 409 5/27/2009
CD4 247/??/VL 161 6/27/2009
CD4 257/21%/VL 60 7/22/2009
CD4 352/22%/VL Undetectable 10/21/2009
CD4 490/27%/VL Undetectable 2/15/2010
CD4 397/?/VL Undetectable 7/2/2010

Offline GSOgymrat

  • Member
  • Posts: 5,002
  • HIV+ since 1993. INTJ
Re: How Much Does HIV Cost in Healthcare Plans.
« Reply #4 on: November 03, 2009, 02:48:31 PM »
I have health insurance through my employer. I spend around $2000 a year out of pocket on healthcare expenses not including what my employer deducts for my health/dental/vision insurance. Those expenses are generally medication, MD office and lab co-pays. I use a flexible spending account through my employer to avoid taxes on those expenses.

Offline chguy78

  • Member
  • Posts: 67
Re: How Much Does HIV Cost in Healthcare Plans.
« Reply #5 on: November 03, 2009, 02:59:25 PM »
I am self-employed and have a private plan with a large health insurance organization.  My policy is up for renewal in January and just increased $15/month for my premium.  In my state, your premium is supposed to increase only for specific reasons: e.g., age, where you live, general costs (not specific to your case). 

So, I pay:

Premiums: $2400/year
Co-payments (office visits): ~5/year x $30/visit = $150/year
Co-payments (rx): 12/year x $35/drug x 3 drugs = $1260/year
Total: $3810
01/11: CD4=753 (36%), VL=Undetectable
07/10: CD4=531 (33%), VL=Undetectable
04/10: CD4=746 (33%), VL=Undetectable
01/10: CD4=566 (35%), VL=Undetectable
10/09: CD4=436 (31%), VL=405
07/09: CD4=631 (27%), VL=847
06/09: Started: Truvada, Reyataz, Norvir
05/09: CD4=426 (28%), VL=38,300
04/09: Positive; CD4=466 (28%), VL=39,700
10/08: Negative

Offline onemoretime

  • Member
  • Posts: 142
Re: How Much Does HIV Cost in Healthcare Plans.
« Reply #6 on: November 03, 2009, 05:53:28 PM »
i spent 2500 this year;  not counting the ins itself work pays for that
08/04 diag 490 cd4 vl 50,000
10/25/05 436 50,513 hvb 1.1 billion
12/13/05 truvada sustiva
02/16/06 742 und, hpb 63,000
04/27/06 740 und hpb 60,000
01/05/07 458 und hvb und
03/08   470 undetectable still on atripla. Non smoking (chantex)
08/08 cd4 550 undetectable hiv, Hep B UND. Atripla
06/09  cd4 444, vl undetectable testo 130
09/09/09 CD4 687 46% UND  Testo 213 started androgel
10/12/09 cd4 682 46% und testo 597
01/12/10 cd4 842 48% und testo 434
041010 cd4 693  53% testo 492
100410 cd4 568 48% testo 523
012711 cd4 523 hcv 56 testo 596
083011 cd4 280 Hcv/HIV und
042912 cd4 158 hcv /hiv und, was on hep c for 11 months. do have ssdi filed and getting LTD
061912 cd4 151, bactrum, hep c and hiv und
071712 cd4 287 52% HIV HCV und
112012 cd4 520

Offline pos2007

  • Member
  • Posts: 116
Re: How Much Does HIV Cost in Healthcare Plans.
« Reply #7 on: November 03, 2009, 08:55:49 PM »
My self pay premium  is $994.00, up  from the  $387.00 it used to  cost  just 2  years ago.  Deductable $2800.00  unless an out  of  network provider;  then  it  is 20% plus $5800.00 deduct.   My bills so far  this  year  have been $101,000.00 not  including  yesterdays hospital/ doctor bills knock on wood mostly  paid by  the  insurance. Medicaid  is paying  for my meds ( 15  now)  since   Healthlink  won't due  to  hiv.  Retail  price  for  my  prescriptions (  I am  sure medicaid  pays a discounted rate)   has  been  just  over $27,000.00 so far this  year. I pay a $2.00 co pay  for  each prescription  each  month. Last  Year HSI/  Adap paid  for  part  of  my  meds till medicaid  finally  started  paying.  My  out  of pocket was still  over $10,000.00 since HSI  & ADAP  wouldn't  pay  for  some  meds nor  would  medicaid. Medicaid  has  finally  picked  up  paying  for all  of  my  meds except 3.  An interesting part,  is  part  of  my meds are available self  pay at a local county  clinic for  under $50.00 but neither medicaid nor  my  insurance  will  pay  for them  at  the clinic nor  will the  clinic accept medicaid  or  insurance,   but   medicaid and will pay for  the  same  meds at  the  doctors office at 12  times  the  price.  Go  figure. ???
« Last Edit: November 04, 2009, 11:37:36 AM by pos2007 »
Diagnosed  CD4 138 VL. 38,000
Partner Diagnosed CD4 <20  VL.  488,000

Offline bufguy

  • Member
  • Posts: 161
Re: How Much Does HIV Cost in Healthcare Plans.
« Reply #8 on: November 03, 2009, 10:02:21 PM »
I'm a civil servant, my insurance is Blue Cross/Blue Shield, Community Blue. I pay no premium for my health care. My co pay for my primary care physician who is also an ID Doc is $5 per visit (once every 4 months). I pay nothing for my labs. I get my Atripla through Medco. Co pay is $30 for 3 month supply.
I am unbelievabl lucky. Health care costs me $135 per year.
5/29/08 confirmed HIV+
6/23/08 Vl 47500  CD4 511/29% CD8 .60
start atripla
8/1/08 Vl 130  CD4 667/31% CD8 .70
9/18/08 Vl un  CD4 not tested
12/19/08 Vl un CD4 723/32% CD8 .80
4/3/09 Vl un CD4 615/36% CD8  .98
8/7/09 vl un CD4 689/35% CD8 .9
12/11/09 vl un CD4 712/38% CD8 .89
4/9/10 vl un CD4 796/39% CD8 1.0
8/20/10 vl un CD4 787/38% CD8 1.0
4/6/10 vl un CD4 865/35% CD8 .9
8/16/10 vl un CD4 924/37% CD8 1.0
12/23/10 vl un CD4 1006/35% CD8 .9
5/2/10 vl un CD4 1040/39% CD8 .9
8/7/13 vl un CD4 840/39% CD8 .9

Offline skeebo1969

  • Member
  • Posts: 5,699
Re: How Much Does HIV Cost in Healthcare Plans.
« Reply #9 on: November 04, 2009, 12:47:21 AM »
I'm a civil servant, my insurance is Blue Cross/Blue Shield, Community Blue. I pay no premium for my health care. My co pay for my primary care physician who is also an ID Doc is $5 per visit (once every 4 months). I pay nothing for my labs. I get my Atripla through Medco. Co pay is $30 for 3 month supply.
I am unbelievabl lucky. Health care costs me $135 per year.

LOL unbelievably lucky is an under statement!   
I despise the song Love is in the Air, you should too.

Offline David_CA

  • Member
  • Posts: 3,245
  • Joined: March 2006
Re: How Much Does HIV Cost in Healthcare Plans.
« Reply #10 on: November 04, 2009, 10:48:19 AM »
I'm a civil servant, my insurance is Blue Cross/Blue Shield, Community Blue. I pay no premium for my health care. My co pay for my primary care physician who is also an ID Doc is $5 per visit (once every 4 months). I pay nothing for my labs. I get my Atripla through Medco. Co pay is $30 for 3 month supply.
I am unbelievably lucky. Health care costs me $135 per year.

I'm in a similar position with BC/BS, though I don't think I can get 3 months of Atripla for $30.  Some things might have changed very recently with our Medco plan, so I'll have to check on that.  It's normally $30 for a month's supply.  My ID Dr. (also my PCP) visits are $25, labs are at no cost, and I pay no premium for my coverage.  I'd say I pay around $80 per month (meds) and $25 x 4 (office visits) for my yearly medical costs.  Like Ford and others, I have a healthcare spending account (Flex account) for drugs and co-pays.  It comes in handy.  I try to not get reimbursed from it too often and save the largest chunk for reimbursement at the end of the year.  It helps with holiday expenses (gifts).  I'd say that those of us with comparable or even remotely similar policies with a company / organization that's not merging or closing are more fortunate than we could imagine.
Black Friday 03-03-2006
03-23-06 CD4 359 @27.4% VL 75,938
06-01-06 CD4 462 @24.3% VL > 100,000
08-15-06 CD4 388 @22.8% VL >  "
10-21-06 CD4 285 @21.9% VL >  "
  Atripla started 12-01-2006
01-08-07 CD4 429 @26.8% VL 1872!
05-08-07 CD4 478 @28.1% VL 740
08-03-07 CD4 509 @31.8% VL 370
11-06-07 CD4 570 @30.0% VL 140
02-21-08 CD4 648 @32.4% VL 600
05-19-08 CD4 695 @33.1% VL < 48 undetectable!
08-21-08 CD4 725 @34.5%
11-11-08 CD4 672 @39.5%
02-11-09 CD4 773 @36.8%
05-11-09 CD4 615 @36.2%
08-19-09 CD4 770 @38.5%
11-19-09 CD4 944 @33.7%
02-17-10 CD4 678 @39.9%  
06-03-10 CD4 768 @34.9%
09-21-10 CD4 685 @40.3%
01-10-11 CD4 908 @36.3%
05-23-11 CD4 846 @36.8% VL 80
02-13-12 CD4 911 @41.4% VL<20
You must be the change you want to see in the world.  Mahatma Gandhi

Offline megasept

  • Member
  • Posts: 478
  • Steven here...
Re: How Much Does HIV Cost in Healthcare Plans.
« Reply #11 on: November 04, 2009, 11:19:41 AM »
Hi: I'll give you the $ amounts so you can compute your own percentages. Nothing like a good employer-based plan. I have the "private option"  :( meaning I have to buy insurance on the market (middleman).

You cannot precisely predict your medical costs because you are a living organism; if you have an older model car you would be wrong to just add up maintenance, tire replacement, brake pads, but exclude repairs. Repairs, even diagnostics can be costly. To make matters worse, your insurer may deny this or that now, even though they paid for the same thing previously.

I spend $11472 on premiums, $1320 on meds (not entirely HIV meds), and enough copays for labs, treatments, diagnostic tests, and visits (negligible), to reach $17000-21000 annually. I also spend $2-6,000 more on dental (I buy dental insurance, but it hardly saves me money). HIV costs plenty more than just meds, especially after many years of infection. Plus older people have more medical problems than younger.

My premiums increased 5 times or 107% over 30 months. HIV, or my utilization of my policy was not the reason. I turned 50 and stayed living for 4 more back-to-back increases. My insurer disrupts treatments and rations my care (I fight back and usually prevail). They absolutely get between me and my MD.

I have been fighting for a Public Option (love Medicare NOW) so I can get out of this insurance scam. I trust my MDs, so that's more important than cost. Future costs? Not a clue.

Good Health!
 8) -megasept
« Last Edit: November 04, 2009, 11:23:32 AM by megasept »

Offline tednlou2

  • Member
  • Posts: 4,762
Re: How Much Does HIV Cost in Healthcare Plans.
« Reply #12 on: November 04, 2009, 08:14:14 PM »
I'm new to this forum.  I notice many put their lab info at the end of their replies.  They all look like the same size print--as if they previously entered their CD-4 and VL info somewhere else on this site and posted it.

Can anyone tell me how this is done?  Or, is everyone just using the same font, font size, and so happen to put lab info in the exact same place following their replies.  Also, I've noticed many didn't know they were poz until CD-4 was dangerously low--such as single digits.  I know statistics show many don't know until their CD-4's have almost totally crashed.  I'm wondering whether these people felt fine until they got some OI like PCP-pneumonia?

I found out last Dec after getting strep-pneumonia--the community acquired kind.  My CD-4 rebounded to over 1,000 and I'm not on meds yet.     

Thanks,
Ted

Offline confidentIwillbeOK

  • Member
  • Posts: 131
Re: How Much Does HIV Cost in Healthcare Plans.
« Reply #13 on: November 04, 2009, 10:05:20 PM »
Ted, go to "Profile" and then  "Forum profile information" and edit the "Signature" section.


 


Terms of Membership for these forums
 

© 2014 Smart + Strong. All Rights Reserved.   terms of use and your privacy
Smart + Strong® is a registered trademark of CDM Publishing, LLC.