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Author Topic: New Health Plan Questions  (Read 9312 times)

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Offline wow1969

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New Health Plan Questions
« on: March 21, 2010, 04:36:53 PM »
Does anyone understand how the new Health Plan will affect us pozzies?

Offline Esquare

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Re: New Health Plan Questions
« Reply #1 on: March 21, 2010, 05:48:11 PM »
For us it should be all positives.

Offline WillyWump

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  • your ramblings bore Yamaguchi Kitteh
Re: New Health Plan Questions
« Reply #2 on: March 21, 2010, 06:03:22 PM »
I have absolutely no idea how it will effect us or anyone else for that matter. I tried following it for awhile but with all the changes over the past months Ive lost track.
POZ since '08

Last Labs-
6/3/14 CD4- 736, UD 34%
6/25/13 CD4- 1036, UD,
2/4/13, CD4 - 489, UD, 28%

Current Meds: Prezista/Epzicom/ Norvir
.

Offline Dachshund

  • Member
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Re: New Health Plan Questions
« Reply #3 on: March 21, 2010, 06:15:05 PM »
It's rather simple. Most of the provisions in the bill won't take effect until 2014. However, in six months insurance companies can no longer deny insurance to children with a preexisting condition, and unisured adults with a preexisting condition will have access to an exchange that will provide coverage until the bill is in full effect. That would be me.

Offline Miss Philicia

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Re: New Health Plan Questions
« Reply #4 on: March 21, 2010, 06:18:18 PM »
I would assume that since this means the implementation of death panels and since pozzies are a net drag on our new socialist economy we'll all get sent to the gallows.
"Iíve slept with enough men to know that Iím not gay"

Offline Matty the Damned

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Re: New Health Plan Questions
« Reply #5 on: March 21, 2010, 06:19:29 PM »
I would assume that since this means the implementation of death panels and since pozzies are a net drag on our new socialist economy we'll all get sent to the gallows.

Firing squads not gallows. We socialists prefer firing squads to the rope.

MtD

Offline Dachshund

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Re: New Health Plan Questions
« Reply #6 on: March 21, 2010, 06:24:06 PM »
Watch Cspan you tired bitches, it's quite the spectacle. We have the votes. The tea baggers called Barney Frank a fag and Congressman John Lewis a nigger. This is your leaner and meaner Republican Party.

Offline Miss Philicia

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  • celebrity poster, faker & poser
Re: New Health Plan Questions
« Reply #7 on: March 21, 2010, 06:26:31 PM »
Watch Cspan you tired bitches, it's quite the spectacle. We have the votes. The tea baggers called Barney Frank a fag and Congressman John Lewis a nigger. This is your leaner and meaner Republican Party.

Calm down missy... didn't you hear that Rep. King (R-Iowa) state that what they said was OK because he doesn't feel safe walking in a black neighborhood?
"Iíve slept with enough men to know that Iím not gay"

Offline phildinftlaudy

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  • sweet Ann what you think babe...
Re: New Health Plan Questions
« Reply #8 on: March 21, 2010, 06:32:36 PM »
It is interesting to watch the debate on tv - at least some of it - as you get to see the true colors of some people.

The elimination of the preexisting condition clause the most insurances have is going to be a great thing.  I remember when I started one of my previous jobs and they had that clause - good thing I was still eligible for Ryan White and had my VA benefits to fall back on otherwise I would have been screwed.  What I wonder is, even if the pre-existing clause is gone - how much will the insurance companies try to charge to provide insurance to those with pre-existing conditions -- they might not be able to exclude - but can they make it cost prohibitive?
September 13, 2008 - diagnosed +
Labs:
Date    CD4    %   VL     Date  CD4  %   VL
10/08  636    35  510   9/09 473  38 2900  12/4/09 Atripla
12/09  540    30    60   
12/10  740    41  <48   
8/11    667    36  <20  
03/12  1,041  42  <20
05/12  1,241  47  <20
08/12   780    37  <20
11/12   549    35  <20
02/12  1,102  42  <20
11/12   549    35  <20

Offline Matty the Damned

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Re: New Health Plan Questions
« Reply #9 on: March 21, 2010, 06:54:53 PM »
Alternatively you can enjoy the splenetic rantings of the lunar right over at Freepersville.

My favourite comment at the moment is from armed retard Flintsliver7 who observes:

If this were 1776 the revolution wouldíve started a long time ago.

Oh yeah.  :)

MtD

Offline Assurbanipal

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Re: New Health Plan Questions
« Reply #10 on: March 21, 2010, 07:34:32 PM »
There's a lot of different ways that HIV+ people get access to care now. 

Some people are employed with employer coverage -- for them the bill means that they don't have to worry about health care coverage as much if they lose their jobs or change employers.

Others are on Medicare -- with the "donut hole" that means there is a big cost of drugs each year if ADAP does not pick it up.  The bill gradually closes the donut hole which should be very helpful for those not on ADAP and serve to relieve some of the pressure on ADAP budgets (potentially fewer people on ADAP waiting lists).

For a lot of younger people (under age 26), they may now be able to get coverage under their parents policies.

It's not going to be paradise ...  But it should be better..
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 azprince

  • Member
  • Posts: 153
Re: New Health Plan Questions
« Reply #11 on: March 21, 2010, 07:43:46 PM »
Assur,
I have few questions please! If I have a maximum limit  on the pharmacy benefits under my current insurance , does this mean that immediately I will be able to keep my insurance pay for my Meds or this clause will not be implemented right away?
I have to admit : the good thing is that from now on;  I have no option but to succeed , still its ok to worry :))

Offline Inchlingblue

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Re: New Health Plan Questions
« Reply #12 on: March 21, 2010, 07:52:44 PM »
  unisured adults with a preexisting condition will have access to an exchange that will provide coverage until the bill is in full effect. 

Are you sure about this? I hope it's accurate but I haven't seen this provision and I'm following this pretty closely.

Offline adhoc

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  • Posts: 28
Re: New Health Plan Questions
« Reply #13 on: March 21, 2010, 09:32:08 PM »
HA  :D The  tea party guys are going to Searchlight! That is the kind of place they need to be! There is nothing there. Its between Las Vegas and Laughlin. It has alot of trailers and one tiny casino and a couple of non working mines. A great place to make a statement on a out of the way state highway and not in a large metro area. Not saying that the people that live there aren't OK but Searchlight is literally "outthere". Back to the subject at hand, If it passes, for everyone here it will be good, especially for those who cant afford insurance or cant get it. For those who  depend on state or public supported programs its a matter of time before alot shut down. I think one in SC and a few in CA just closed down (correct me if I'm wrong I think I read about a couple here). It concerns me that the states are cutting these programs and cutting education like they are. Hopefully this passes as it will relieve a lot of worries for everyone. Also for me I have insurance, I bought it prior to my diagnosis and I will no longer have to be locked into my locale and will open up options for people who want to relocate as one of my concerns is leaving my current insurance and not being able to get it again if I have to move, especially in this economy with work the way it is. Just my two cents.
alea iacta est

Offline Dachshund

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Re: New Health Plan Questions
« Reply #14 on: March 21, 2010, 09:41:48 PM »
Are you sure about this? I hope it's accurate but I haven't seen this provision and I'm following this pretty closely.

I'm pretty sure. I know almost immediately children won't be denied insurance because of a preexisting condition. From my reading of the bill  uninsured adults with a preexisting condition will have access to an exchange (it's not comprehensive coverage) until the bill kicks in in 2014.

Offline Assurbanipal

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  • Taking a forums break, still see PM's
Re: New Health Plan Questions
« Reply #15 on: March 21, 2010, 10:05:21 PM »
I'm pretty sure. I know almost immediately children won't be denied insurance because of a preexisting condition. From my reading of the bill  uninsured adults with a preexisting condition will have access to an exchange (it's not comprehensive coverage) until the bill kicks in in 2014.

It's not "technically" an exchange, which may be why it did not ring a bell with Inchling.  Instead it is access to a high risk pool.

It was in the Senate bill, section 1101.  This summary of "immediate" changes says that people who have been denied coverage will have access to a high risk pool effective 90 days after enactment.  See item 12 http://docs.house.gov/energycommerce/IMMEDIATE_PROVISIONS.pdf
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 Assurbanipal

  • Member
  • Posts: 2,173
  • Taking a forums break, still see PM's
Re: New Health Plan Questions
« Reply #16 on: March 21, 2010, 10:09:38 PM »
Assur,
I have few questions please! If I have a maximum limit  on the pharmacy benefits under my current insurance , does this mean that immediately I will be able to keep my insurance pay for my Meds or this clause will not be implemented right away?

It is not clear how the annual limits will work under the bill.  The Senate bill prohibited lifetime limits and said annual limits had to be "reasonable" under guidance that applied to high deductible plans as issued by the IRS.  (Section 2711 of the Senate bill) Presumably this meant IRS (and Treasury) would issue regulations defining what was and was not reasonable.

But the reconciliation bill overrides this and says HHS will define what a "reasonable" annual limit will be,  The new limits are to be effective 6 months after the Bill is signed into law.  See section 8 in the link http://docs.house.gov/energycommerce/IMMEDIATE_PROVISIONS.pdf

So...sorry but it is too early to tell how that will work in any detail

A
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 Assurbanipal

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  • Taking a forums break, still see PM's
Re: New Health Plan Questions
« Reply #17 on: March 21, 2010, 10:14:09 PM »
I posted some of these links in a different thread -- but there is a lot of information available on the bill including timelines, section by section details, list of consumer protections etc.  at the following website for the Speaker of the House.

http://www.speaker.gov/newsroom/legislation?id=0361

Scroll down to see the various summaries.
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 Rev. Moon

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  • Smart ass faggot ©
Re: New Health Plan Questions
« Reply #18 on: March 21, 2010, 11:24:27 PM »
"I have tried hard--but life is difficult, and I am a very useless person. I can hardly be said to have an independent existence. I was just a screw or a cog in the great machine I called life, and when I dropped out of it I found I was of no use anywhere else."

Offline tednlou2

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Re: New Health Plan Questions
« Reply #19 on: March 21, 2010, 11:54:59 PM »
Are you sure about this? I hope it's accurate but I haven't seen this provision and I'm following this pretty closely.

I was watching ABC when they broke in right before 11pm EDT.  Diane Sawyer mentioned this part of the bill that would help adults with preexisting conditions until it takes full effect in 2014.  I had never heard of it either until she said it.  I also learned Medicaid will be greatly expanded.  Eventually, no one should ever have to go bankrupt, because they got sick.  As we all know, healthcare bills are the number one reason for bankruptcies. 

It is a very good start, but not perfect by any means.  Not to get too off topic, but it just amazes me how people who claim to be Christian would try to stop this.  Start an illegal war that costs over $2 Trillion--fine.  Try to help people, forget it. 

Offline WillyWump

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  • your ramblings bore Yamaguchi Kitteh
Re: New Health Plan Questions
« Reply #20 on: March 22, 2010, 12:28:57 AM »
It's not "technically" an exchange, which may be why it did not ring a bell with Inchling.  Instead it is access to a high risk pool.

It was in the Senate bill, section 1101.  This summary of "immediate" changes says that people who have been denied coverage will have access to a high risk pool effective 90 days after enactment.  See item 12 http://docs.house.gov/energycommerce/IMMEDIATE_PROVISIONS.pdf

"12.
IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH‐RISK POOL)óProvides immediate access to insurance for Americans who are uninsured because of a pre‐existing condition ‐ through a temporary high‐risk pool. Effective 90 days after enactment."


Is there any indication anywhere as to what it might cost to enter the "high risk pool"? If it's cost prohibitive, then it does no good. If the govt is paying for it, How?
POZ since '08

Last Labs-
6/3/14 CD4- 736, UD 34%
6/25/13 CD4- 1036, UD,
2/4/13, CD4 - 489, UD, 28%

Current Meds: Prezista/Epzicom/ Norvir
.

Offline tednlou2

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  • Posts: 4,816
Re: New Health Plan Questions
« Reply #21 on: March 22, 2010, 01:02:18 AM »
I was reading a question to a doc on thebody.  This just reinforces why we need healthcare reform.  This guy is stopping meds waiting for COBRA.  First, I don't see how anyone unemployed can afford COBRA.  You have to pay your share plus what your employer's share was.  I would think being out of work he would qualify for ADAP.  Then again, we've been talking about all the waiting lists for that.  It is just sad people have to make decisions like this.  Below is the Q&A:

suspending meds for 30 days till COBRA updates
Mar 21, 2010

I found out that I was HIV+ in Nov. 2008. Around that time I had a vl=81400 and CD4=118. I suspect that I had been unknowingly infected for some 8-10 years or so. Anyway, after receiving my diagnosis in 11/08, I soon began meds in 02/09. I was lucky enough to be a participant in a clinical study involving Isentress and Atazanvir (2 pills each, twice daily). At the start of my treatment my vl=97900 and CD4=138. In less than 2 months, my vl became undetectable and my CD4 rose to 194 (213 was highest achieved). The study was originally supposed to last for 2 years; but was unfortunately discontinued after 1 year of treatment. Last results: vl=UD, CD4=167.

Around the same time, I lost my job and am waiting to begin COBRA so that I might start paying for my meds. I found out today, that it takes approx. 30 days for Cobra to kick in, and I only have 1 weeks worth of current trial meds available before leaving the study. My doctor has written me new Rx's for Isentress and Truvada. I also have an appoinment with a social case worker to assist me in obtaining financial help going forward. I understand that I will have to pay out-of-pocket (full retail) for my new scripts for at least the first month (total $2300). I simply do not have this considering I'm currently unemployed.

Question: Considering my history, current vl and CD4, how terrible would it be if I simply stopped taking any meds until my insurance was re-instated (approx. 1-month)?

I have done some research and feel that I would be ok in regards to developing resistance. However, I'm not sure considering my CD4 is still < 200. I haven't spoken to my HIV specialist about this idea yet; but plan to do so this week. Any suggestions?

Thanks for all you do. This site is invaluable.

 
 
 
Advertisement
 
     Response from Dr. Holodniy

I can certainly understand the financial squeeze on you regarding your meds. Although it is not the optimal decision, stopping for 30 days is unlikely to affect any future HIV med regimens being able to get you back to undetectable and I agree, development of resistance would be unlikely. A couple of things to point out. First, make sure you at least are taking bactrim or septra once daily to protect you from serious opportunistic infections. That should be relatively cheap to continue. Second, you may suffer from a viral load rebound syndrome, where you might develop flu like symptoms or fever after discontinuing HIV meds.

 

Offline Assurbanipal

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  • Posts: 2,173
  • Taking a forums break, still see PM's
Re: New Health Plan Questions
« Reply #22 on: March 22, 2010, 07:29:49 AM »
"12.
IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH‐RISK POOL)óProvides immediate access to insurance for Americans who are uninsured because of a pre‐existing condition ‐ through a temporary high‐risk pool. Effective 90 days after enactment."


Is there any indication anywhere as to what it might cost to enter the "high risk pool"? If it's cost prohibitive, then it does no good. If the govt is paying for it, How?

The Senate bill (Section 1101) sets aside $5 billion to subsidize the high risk pools.  The policies have a wider range of vairation based on age (4 to 1) and a lower mandated benefit value (65%) than the policies in the exchanges and there is no explicit discussion of subsidies based on ability to pay. 

But it is expected that most of these high risk pools will be set up by the States, which may provide some subsidies as well.  So ... too soon to tell, and affordability will probably vary by State.
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 Inchlingblue

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  • Chad Ochocinco PETA Ad
Re: New Health Plan Questions
« Reply #23 on: March 22, 2010, 10:35:17 AM »
Thanks to everyone who provided additional info. about these pools. I wasn't aware of them. It sounds great as long as they aren't prohibitively expensive.

Offline randym431

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Re: New Health Plan Questions
« Reply #24 on: March 22, 2010, 08:43:25 PM »
Rep. King (R-Iowa) is one nasty person. He's said a lot worse. This must have been one of his more sane days.  :o

As to 2014, hey kiddies... Keep the democrats in power and they will likely tweak this starting point to a much earlier date. It only gets better " IF  " democrats remain in control, for us non 100mill yearly salary folks that don't happen to own a 20 million home on the beach in Florida. Yes Im talking about those rich self serving radio show hosts and former presidential candidate losers. Oh.. and that creepy lady that can see Russia from her house.   8)

Offline Jody

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Re: New Health Plan Questions
« Reply #25 on: March 22, 2010, 09:47:50 PM »
I was glad to see this pass of course, but being a bit of a worry wort I fear the individual states could try to water it down with Republicans behind the effort to do so.  A tax break for Exxon-Mobil is their only platform it seems.  History tells us that back in the 1930's the same kind of hateful folks blasted Social Security for the elderly and disabled as "communism".  The sons of guns (yes!) threw the same term around back in the 1960's when Medicare came into existence.  They can't debate so they shout slurs at otherwise decent people, it is a weakness and folks should see through it.  I'm not perfect to be sure but I strive daily to be a better person than those ultra-conservatives and their angry minions, or since they like to throw around the commie term maybe we can just call them Fascists, but a name game serves no purpose.

Anyway this Tea Party movement is a bit frightening, you wonder what classless and dangerous things they're capable of if heaven forbid we dip into a major recession or even a Depression.  Some of them are certainly the types who will first burn books, then people.  Really!!!  

Jody
« Last Edit: March 22, 2010, 09:54:03 PM by Jody »
"Wake up to find out that you are the eyes of the world".
 "Try to discover that you are the song that the morning brings."

Grateful Dead

Offline decayingsinner

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Re: New Health Plan Questions
« Reply #26 on: March 22, 2010, 10:24:19 PM »
Glad to hear about this but man these Republics make me more furious by the second.

Offline Assurbanipal

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Re: New Health Plan Questions
« Reply #27 on: March 23, 2010, 01:26:42 PM »
A couple more good things in the bill :

1) Some states only allow children and their parents and the dsabled onto Medicaid.  Single individuals who are not disabled can't get onto Medicaid in those states.  The Bill will expand Medicaid to cover people who can still work in all states whether or not they are "single", up to 133% of the poverty threshold. (This one generated some heated discussion in the Forums last year)

2) The bill prevents states from cutting back existing Medicaid eligibility provisions, effective on enactment.  So States that already allow poor working single people into Medicaid cannot balance their state budget by kicking people out as of this morning when the President signed the Bill.
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 LordBerners

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Re: New Health Plan Questions
« Reply #28 on: March 23, 2010, 01:44:18 PM »
1) Some states only allow children and their parents and the dsabled onto Medicaid.  Single individuals who are not disabled can't get onto Medicaid in those states.  The Bill will expand Medicaid to cover people who can still work in all states whether or not they are "single", up to 133% of the poverty threshold. (This one generated some heated discussion in the Forums last year)

Yes!  This is the provision that I found most likely to benefit me - I'm likely to have little or no income if I go back to the US, and this seems to mean that I would get Medicaid. 

I have two questions: first when does this provision kick in?  Presumably 2014?  And secondly, would that mean that a person getting Medicaid under those terms would get their hiv medicines from Medicaid instead of ADAP?  I wonder if Medicaid covers all meds..
Please, just call me Berners.. or Baron.

Offline Assurbanipal

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Re: New Health Plan Questions
« Reply #29 on: March 23, 2010, 02:03:37 PM »
Yes!  This is the provision that I found most likely to benefit me - I'm likely to have little or no income if I go back to the US, and this seems to mean that I would get Medicaid. 

I have two questions: first when does this provision kick in?  Presumably 2014?  And secondly, would that mean that a person getting Medicaid under those terms would get their hiv medicines from Medicaid instead of ADAP?  I wonder if Medicaid covers all meds..

States that choose to expand Medicaid will get some federal support in 2010.  But the requirement to expand Medicaid to cover all non-elderly under 133% of the poverty line s a 2014 provision.

But States are currently all over the place in what they offer.  You really need to talk to someone knowledgeable in the State you intend to move to and see what it offers.

You may find this chart at the Kaiser Family foundation State Health Facts page helpful in seeing which states recently allowed people on ADAP into Medicaid.  For the US as a whole, 11% of people receiving ADAP were on Medicaid but that is an average of a lot of States with 0% and some States with as much as 60% covered (Maine)
http://www.statehealthfacts.org/comparetable.jsp?ind=542&cat=11
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 Inchlingblue

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Re: New Health Plan Questions
« Reply #30 on: March 23, 2010, 03:06:54 PM »
A friend of mine who has HIV lives in AZ and he gets Medicaid (they call it AHCCCS). It covers all his meds and doctor appointments, it's basically comprehensive health insurance.

The thing is the current governor, a conservative Replublican, because Obama "stole" the previous liberal lesbian by offering her a job so she had to resign (Janet Napolitano), now intends to drop coverage to children who are eligible for the CHIP program (the only state considering this) as well as to many "single" adults on AHCCCS in order to balance the budget.
« Last Edit: March 23, 2010, 04:23:19 PM by Inchlingblue »

Offline wow1969

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Re: New Health Plan Questions
« Reply #31 on: March 23, 2010, 10:02:08 PM »
Thanks for the responses .. I think I'm still confused .. UGH

Offline justaguy

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Re: New Health Plan Questions
« Reply #32 on: March 23, 2010, 10:38:34 PM »
I have a HIV+ friend who has pretty bad insurance through work, but good income (just over $100k per year) and we've debated this thing until blue in the face.  His meds are only covered 50% through his work policy, so he's paying somewhere around $900 a month for meds out of pocket (after tax).  He and I hoped this bill would help his situation, since he could then go out and apply for a separate new policy to help cover the meds, outside of work.  But according to him the clause forcing coverage of pre-existing conditions doesn't set a limit on how much they can charge, so they could charge as much as $2,000 a month for coverage for him, so it would be pointless to do that.  Also, it changes levels of Flexible Spending Accounts, to lower numbers ($2,500), which hurts him since that's what he uses to pay his $900 per month, and also raises the medical expense deduction for income taxes from 7.5 to 9.5%, which also hurts him since he won't quite meet that if paying $900 a month.  Is this true?  He is pretty irate about it.  I can't find that it will change anything for me, but from what I'm reading, I have a so-called "Cadillac plan", and I'm worried about increased tax burden for that?  I do like the protections (exchanges, etc) it creates if we pozzies were to lose our jobs, or if we wanted to start our own businesses, but then again, my state already had a high-risk pool that I could have qualified for, so I have to wonder how redundant that is?
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 Inchlingblue

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Re: New Health Plan Questions
« Reply #33 on: March 24, 2010, 12:05:24 AM »
I have a HIV+ friend who has pretty bad insurance through work, but good income (just over $100k per year) and we've debated this thing until blue in the face.  His meds are only covered 50% through his work policy, so he's paying somewhere around $900 a month for meds out of pocket (after tax). 

Not to hijack the thread but you should tell your friend about co-pay assistance programs. I have two big co-pays until I meet the deductibles at the beginning of the year and Truvada and Isentress co-pay programs covered $600. for both January and February for a total of $1200.

LINK:

http://positivelyaware.com/2009/09_02/13th_annual_hiv_drug_guide.shtml

Offline RapidRod

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Re: New Health Plan Questions
« Reply #34 on: March 24, 2010, 04:16:19 PM »
It's rather simple. Most of the provisions in the bill won't take effect until 2014. However, in six months insurance companies can no longer deny insurance to children with a preexisting condition, and unisured adults with a preexisting condition will have access to an exchange that will provide coverage until the bill is in full effect. That would be me.
Wrong because they didn't read the bill and voted on it children will not get the preexisting condition care until 2014 like adults. Same with closing the loop hole in medicare and medication price reduction. They were in a rush to pass a bill that now it has to be changed and revoted on.

Offline Assurbanipal

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Re: New Health Plan Questions
« Reply #35 on: March 24, 2010, 06:00:13 PM »
Wrong because they didn't read the bill and voted on it children will not get the preexisting condition care until 2014 like adults. Same with closing the loop hole in medicare and medication price reduction. They were in a rush to pass a bill that now it has to be changed and revoted on.

Rapidrod
Dachshund appears to be referring to the two bills as a package:
- the Senate version of health care reform which the House passed and the President signed
- the additional changes agreed to by the House and Senate leadership which were set forth as a separate bill and have passed the House and are now being debated in the Senate. 

The suggestion that the second bill is needed because the first Bill had not been adequately read and vetted is just not true -- not to say that typo's and poorly phrased bits won't need to be fixed in the future (almost every big bill has several sets of "technical corrections "  its a routine part of the political process) -- but these are about additional policy changes on top of those in the Senate bill which form a package in the minds of the Democratic leadership.
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 Assurbanipal

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Re: New Health Plan Questions
« Reply #36 on: March 24, 2010, 06:58:13 PM »
I have a HIV+ friend who has pretty bad insurance through work, but good income (just over $100k per year) and we've debated this thing until blue in the face.  His meds are only covered 50% through his work policy, so he's paying somewhere around $900 a month for meds out of pocket (after tax).  He and I hoped this bill would help his situation, since he could then go out and apply for a separate new policy to help cover the meds, outside of work.  But according to him the clause forcing coverage of preexisting conditions doesn't set a limit on how much they can charge, so they could charge as much as $2,000 a month for coverage for him, so it would be pointless to do that.  Also, it changes levels of Flexible Spending Accounts, to lower numbers ($2,500), which hurts him since that's what he uses to pay his $900 per month, and also raises the medical expense deduction for income taxes from 7.5 to 9.5%, which also hurts him since he won't quite meet that if paying $900 a month.  Is this true?  He is pretty irate about it.  I can't find that it will change anything for me, but from what I'm reading, I have a so-called "Cadillac plan", and I'm worried about increased tax burden for that?  I do like the protections (exchanges, etc) it creates if we pozzies were to lose our jobs, or if we wanted to start our own businesses, but then again, my state already had a high-risk pool that I could have qualified for, so I have to wonder how redundant that is?

Justaguy

In a Nyquil/Norvir haze I typed up and lost a long response this morning (Note -- just because Sudafed mixes ok with Norvir does not mean Nyquil does  :) )  Sorry

On your friend's issues:
1) If he has coverage now it is not clear that he would even be able to participate in the high risk pools.  They are intended as a stopgap measure until 2014 for people who can't get coverage at all -- not for people who have coverage but don't like it.  As a stop gap for people who are really in desperate straits they are not expected to be as affordable or as protective as the long term solution.  That said, the bill does set aside $5billion to try to help keep the cost of these policies relatively affordable.  But comparing his current coverage to what he sees in the risk pools is, well ...

2) There has been a thread of discussion running through the whole healthcare debate that it is somehow almost unpatriotic to suggest that America does not have the best health care.  All this stuff about some Canadian official having an operation in the US is hauled out to say that because he was able to pay for the best that American health care could offer, so can all Americans.  Yes, some parts of American health care are superb, but in total the quality and access to health care in America is less even.  In round numbers about 30 million people don't have health insurance at all, and about 20,000 or so of them die each year because they don't.  And about 60 million people have health care insurance that is so cheap and riddled with holes that when they actually need it a sizable fraction of them go bankrupt -- about a third of all bankruptices in this country are due to bad health insurance that doesn't pay for squat (and another third of bankruptices are due to people not having adequate disability income insurance). 

The health care reform is mainly about bringing these 90 million people's benefits up.  It sounds like your friend's policy might be one of the rotten ones, or it might be just a bit better.  If it is one of the rotten ones, he will benefit from reforms that will make his employer fix some of the worst flaws -- for instance by not allowing lifetime caps or unreasonable annual caps on benefits.  If it is marginally above a rotten policy, (only "lousy"   :P)  then the legal changes may not directly affect his policy.  And giving up the employer subsidy and buying a decent policy from the exchanges is probably not going to be a good financial move. 

So, is he out of luck? 

Well... probably not.  The policies in the exchange will be out there for everyone to see, and employer health plans that are clearly inferior are going to stick out.  Employers with those lousy policies will see a lot of pressure from employees in hiring and the potential for bad news media coverage.  So there will be a lot of pressure on those employers to upgrade their plans to be at least as good as the exchanges or to cancel their plans and give their employees the money to shop for a plan.  So eventually, you can see the exchange plans as providing a competitive floor on health plans -- employees won't want to settle for less.

3) Your friend is right about the health spending account limit decreasing.  The limit on deducting health expenses actually goes up to 10% of income not 9.5% -- but that is in 2013.



As far as your concerns about the Cadillac tax -- 2018 is a long time from now, and health plans usually change a lot over any 5 year period.  The chance that you would still be working there and that no changes would have happened to the plan by then are probably pretty small.  And if you should change jobs you will have a lot of additional protections under the new law.  So, you need to balance the long term risks vs opportunities for yourself and also look at the long term added protections for 90 million of your fellow citizens.



Finally, when Social Security was first enacted it was amended quite frequently to deal with unintended consequences, add improvements etc.  The same is likely here.  But first we had to have something to improve.

A
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 RapidRod

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Re: New Health Plan Questions
« Reply #37 on: March 24, 2010, 07:21:46 PM »
Rapidrod
Dachshund appears to be referring to the two bills as a package:
- the Senate version of health care reform which the House passed and the President signed
- the additional changes agreed to by the House and Senate leadership which were set forth as a separate bill and have passed the House and are now being debated in the Senate. 

The suggestion that the second bill is needed because the first Bill had not been adequately read and vetted is just not true -- not to say that typo's and poorly phrased bits won't need to be fixed in the future (almost every big bill has several sets of "technical corrections "  its a routine part of the political process) -- but these are about additional policy changes on top of those in the Senate bill which form a package in the minds of the Democratic leadership.
I'm talking about the Healthcare Bill that was just signed into law on tuesday, that Obama claimed that would take care of preexisting conditions for children in 60 days after his signature. Well it is not going to happen in 60 days.

Offline Assurbanipal

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Re: New Health Plan Questions
« Reply #38 on: March 24, 2010, 09:41:43 PM »
I'm talking about the Healthcare Bill that was just signed into law on tuesday, that Obama claimed that would take care of preexisting conditions for children in 60 days after his signature. Well it is not going to happen in 60 days.

The President actually referred to the package of both bills.  He said:

"In a few moments, when I sign this bill, all of the overheated rhetoric over reform will finally confront the reality of reform. (Applause.) And while the Senate still has the last round of improvements to make on this historic legislation --

Audience Member: Yes.

President Obama: -- and these are improvements I'm confident they will make swiftly -- "

Read the VP's and President's signing speeches here http://www.nytimes.com/2010/03/24/us/politics/24health-text.html?pagewanted=2

Yes We Did!

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 Inchlingblue

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Re: New Health Plan Questions
« Reply #39 on: March 24, 2010, 09:53:29 PM »
I think Rod is referring to something about the language being vague re: children with pre-existing conditions but HHS intends to fix this in the next 30 days.

LINK:

http://www.fiercehealthcare.com/story/health-reform-currently-leaves-kids-coverage-incomplete/2010-03-24

Offline Assurbanipal

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Re: New Health Plan Questions
« Reply #40 on: March 24, 2010, 09:59:59 PM »
I think Rod is referring to something about the language being vague re: children with pre-existing conditions but HHS intends to fix this in the next 30 days.

LINK:

http://www.fiercehealthcare.com/story/health-reform-currently-leaves-kids-coverage-incomplete/2010-03-24

Spin, Inchling and don't fall for it.

If the Secretary can specify it by regs under the law and does, it is IN the law.


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 RapidRod

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Re: New Health Plan Questions
« Reply #41 on: March 24, 2010, 10:05:09 PM »
Assurbanipal, here is the link so that you will know what you are talking about.  

http://www.google.com/hostednews/ap/article/ALeqM5jYnajhWrPEXihcCrpRNfUKN7rN-AD9EKTKIG0

They screwed the bill up and no one caught it until today.
« Last Edit: March 24, 2010, 10:08:12 PM by RapidRod »

Offline Inchlingblue

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Re: New Health Plan Questions
« Reply #42 on: March 24, 2010, 10:51:20 PM »

If the Secretary can specify it by regs under the law and does, it is IN the law.


I agree.

Offline tednlou2

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Re: New Health Plan Questions
« Reply #43 on: March 25, 2010, 12:04:28 AM »
Wrong because they didn't read the bill and voted on it children will not get the preexisting condition care until 2014 like adults. Same with closing the loop hole in medicare and medication price reduction. They were in a rush to pass a bill that now it has to be changed and revoted on.

On the evening news tonight, the Obama Administration said their lawyers are looking at this and believe it can be corrected without having to be voted on again.  This is what they are saying at least.  We'll see.

Offline Assurbanipal

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Re: New Health Plan Questions
« Reply #44 on: March 25, 2010, 07:07:29 AM »
After 25 years of closely following new federal legislation:

- 1000+ page bills are not uncommon, no matter who controls Congress
- There are always a few issues where someone will look back and wonder if they phrased something correctly
- Usually it is fixable by regulations
- Sometimes it requires "technical corrections"  You will find pages of them at the back of other bills (part of the reason 1000+ page bills are not uncommon)

It is only the hyper-politicized nature of the debate that brings "issues" like these out and where cynical,  faux populist legislators, analysts or reporters try to pretend they are new or have any meaning.
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 Dachshund

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Re: New Health Plan Questions
« Reply #45 on: March 25, 2010, 08:02:00 AM »
I know Roddles is just gleeful hoping that children with preexisting conditions might somehow derail this bill. Don't worry Ro-Ro you're going to be able to keep you're socialist, government run healthcare that the tax payers pay for. However, the technical, parliamentarian rules that sent the bill back to the house will be corrected and the bill will be passed. No matter what the folks at Fox tell you.


Offline RapidRod

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Re: New Health Plan Questions
« Reply #46 on: March 25, 2010, 09:05:53 AM »
I know Roddles is just gleeful hoping that children with preexisting conditions might somehow derail this bill. Don't worry Ro-Ro you're going to be able to keep you're socialist, government run healthcare that the tax payers pay for. However, the technical, parliamentarian rules that sent the bill back to the house will be corrected and the bill will be passed. No matter what the folks at Fox tell you.


Again someday I want to meet you personally and thank you for taking care of mine and several other million people's healthcare.

Offline Miss Philicia

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Re: New Health Plan Questions
« Reply #47 on: March 25, 2010, 09:15:18 AM »
I know Roddles is just gleeful hoping that children with preexisting conditions might somehow derail this bill. Don't worry Ro-Ro you're going to be able to keep you're socialist, government run healthcare that the tax payers pay for. However, the technical, parliamentarian rules that sent the bill back to the house will be corrected and the bill will be passed. No matter what the folks at Fox tell you.



He claimed all of this was dead in the water six months ago anyway.  Not like he's ever, ever right about anything of a political nature, but whatever.
"Iíve slept with enough men to know that Iím not gay"

Offline Dachshund

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Re: New Health Plan Questions
« Reply #48 on: March 25, 2010, 10:31:52 AM »
Again someday I want to meet you personally and thank you for taking care of mine and several other million people's healthcare.

Don't waste your bus fare comrade, your sincere online "thanks" is all I need. Spend that money on a tractor pull. It's on me! :-*

Offline RapidRod

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Re: New Health Plan Questions
« Reply #49 on: March 25, 2010, 12:08:25 PM »
Don't waste your bus fare comrade, your sincere online "thanks" is all I need. Spend that money on a tractor pull. It's on me! :-*
Nah, that just doesn't seem like it's personal enough. And for your friend the bill didn't get passed back then and it's not over with yet.

 


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