Meds, Mind, Body & Benefits > Insurance, Benefits Programs & HIV

Suggestions for Self-Employed Insurance

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Generic atripla can be purchased online for as little at $168 for a 30 day supply,  cheaper if you buy in quantity. has a good reputation.

NoRegrets, one thing I think that has already been suggested is COBRA for 18 months.  Are you in a position where if you decided to quit your job, you can A) Afford the COBRA cost, B) easily get back into the industry and a job if you can't find replacement insurance through a state health exchange that you can afford.

I was in your shoes a few years ago.  I would check to see if your state currently has a "high risk pool".  I live in one of the most backwards red states in the nation, and we actually had a really good one in place when I decided to become self employed about three years ago.  Basically, all insurance companies in this state put money in to this system to help subsidize the higher cost of high risk patients like us with pre-existing conditions.  You have to pay a premium that is slightly higher than the standard rate for an individual your same age with no pre-existing conditions.  There was no basis on income or anything like that.  My state allowed you to qualify based on several different criteria, but basically all I had to do was get a letter from my doctor indicating my status/diagnosis, prove that I had been covered by insurance for the last year or something like that, and I qualified immediately.  I think some conditions require that you prove you have been rejected by other insurance companies, but HIV was kind of like a hall pass that let me bypass that.  I'm in my mid-late 30's, my monthly premium is around $350, with a $1,000 annual deductible, and $100 per month copay for my Atripla.  Other medicines that they don't call "specialty" meds are lower, usually $15 or $30.  I usually spend around $6,500 per year including premiums, but I only go for labs every 9-12 months since things are so stable with my numbers, and since my deductible is $1,000 I usually have to pay it all out of pocket, around $3-500 depending on what the doctor is checking.  I'm not sure what's going to happen once 2014 rolls around.  Since individual market insurance policies won't be allowed to deny based on pre-existing conditions, I have to wonder if the high risk pools will be going away?  I've done some shopping around, and I can't really find any kind of great deal on the regular individual plans out there now.  Most have horrible prescription plans!  20-50% copay on meds, or the meds have an annual deductible that has to be met.  I honestly have no complaints about what I have right now, even though it's not nearly as sweet as the group health insurance I walked away from.

Another suggestion that several people gave to me when I was looking was to check with any professional organizations (i.e., bar association or even college alumni groups).  Nothing I qualified for had individual health plans, they all required a group of 2 or more, but apparently that route does work for some people.

Edited:  Just googled, doesn't look like Virginia has a plan in place, but NC does..

Hello  I live in New York and have AmidaCare insurance. They cover 100% of my medications. There is no out of pocket expense even to see a specialist. Here is the number for more information: I had Adap at first and even then I had no copay for medications. I would recommend others to look to AmidaCare. They are a Managed Care type of insurance specifically for Hiv/Aids patients

Jeff G:
Hi Dballin and welcome to the forums . I removed the phone # from your post because we do not encourage any marketing on the site . If members wish to web search the company they can do so on their own .

I assume you are HIV positive yourself from your post ?  . It would be nice if you shared a little about yourself so we can get to know you . Thanks , Jeff .   


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