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

Suggestions for Self-Employed Insurance

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--- Quote from: Jmarksto on July 10, 2013, 11:12:23 PM ---Mitch; Thanks for the reply -- I am hoping that there is an obamacare plan that reduces the cost, but I am not holding my breath.  Right now my insurance is about $9k/year. My doctor visits arn't bad at a $30 copay, but the labs kill me - its about $300 - $400 every time my labs are done, and my co pay on my meds is 50%!!!!  I'll be curious to see what comes out in the next year....

--- End quote ---
Yikes! A $9000/year plan with only 50% med coverage? And poor lab coverage?! >:(
You must be paying over $20,000/year out of pocket including insurance. :(
(it's around $15,000 for me)

--- Quote from: noregrets on July 10, 2013, 11:40:31 PM ---Thanks for the replies, guys.  The labs are something I hadn't even considered when I did my original post.  I'm going to the doctor about every 3 months now (bc I'm close to undetectable, but not quite yet) & that's a fortune each time.  Luckily, my current provider is great with that, they usually end up costing me about $100 each trip. I'm not sure with the new coverage I've been looking at what that might run.

How about Ryan White or state help?  At what point can you at least get some assistance usually?  I hate to ask about that bc I'd much rather  just buy my insurance & do it myself but they make it practically impossible.

--- End quote ---
My labs are covered under my plan. (with a $20 co pay if I get my blood draw at the hospital clinic)

Never looked into Ryan White. I think it income based and might vary by state. ADAP is also income based and does vary by state. Some states requirements are much better/easier than others. I think in Connecticut it is 400% of poverty level. We also have state assistance available for insurance coverage but I don't know the details. (I read them once and didn't think I qualified)
Anyway, I would look into it. Maybe your local ASO could help.

I am currently self-employed working as a consultant after leaving my last job December 2012.

I have insurance coverage under COBRA and now pay about $485 a month premium. I also pay the $30 co-pay for doctor visits (I see him twice a year) and $0 or $30 prescription refill co-pay depending on the generic or brand name.

The COBRA coverage can go for 18 months and I can request an extension if needed.

I also have been checking out market insurance coverage here among other places:

There is an article in NYTImes today about how the new health care law will cut premiums in half for the self- insured in NY. Savings should be similar in other states who adopt the insurance exchanges.   Of course, these will all be different and probably in the South - not so much.

As for ADAP the limits vary widely state to state. In NY and PA dollar limits can be as high as 90k before you stop receiving benefits.  In Georgia and some other states people die on the waiting lists. I urge you to find out the exact limits for your state. I myself am moving to Oregon. Hope to see you there.  :)


I am in Oregon, so we look forward to seeing you here!

Regarding the Oregon plan "Cover Oregon", here is the link:

I don't qualify for any financial benefits (ie. tax deductions) based on my annual income and family size, and it isn't clear if Cover Oregon would allow me to buy insurance through them to get a better plan than I have now with no pre-existing condition restriction.

Again, welcome to Oregon!


Thanks for the info and the welcome! Although I am not there yet I have been conducting my own informal study on the best cities to live with HIV. I'm comparing ADAP services, rental costs and Walkscore. The obvious places like Boston and New York are prohibitively expensive as is San Francisco. So far, Portland and Pittsburgh are the leaders. I lived in Pennsylvania most of my life however, and the winters are brutal.

The CAREAssist program looks great:

and it may seem like a small thing but they have a great website.  I've often wondered why if Target and Nordstrom can design a friendly website the knack eludes government agencies.

I should be out there in a few months, thanks so much.



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