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

Relocation, Health Insurance, Assistance, etc

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Having recently moved from NC, my home state of 39 years, across the country to Southern California, I thought I'd share my experiences with and what I've learned about ADAP, Ryan White, COBRA, and related assistances.  I know this will likely not apply to many other states, but I wanted to point it out as to options that are often available.  In fact, I've met people here who didn't enroll in COBRA when they lost their jobs and went on ADAP / Ryan White simply because they didn't know about the insurance premium assistance program.  I only knew to look into it from other posts I've read on the forums from members living in other progressive states.

In NC, I was a state employee for 12 years and had great insurance - a PPO with BC/BS that is accepted almost everywhere in the US.  It was also free to me initially, though it did cost me $20 per month the last couple years.  Hubby and I have wanted to relocate for some time for a variety  of reasons.  One of the main reasons I was hesitant was my concern of not having my insurance and being HIV+.  I know many states have waiting lists for ADAP / Ryan White and unrealistic (very low) income limits that are very unrealistic.  In a nutshell, that fear kept me from seriously considering a relocation; I was trapped in my job in an area that I had become unhappy with.  Yes, I was thankful that I had housing, a decent job,
great benefits, security, etc.  Still, we needed a change. 

An opportunity that was too good to pass up, along with a few other things, made the relocation possible.  Still there's that pesky issue of meds and HIV care.  As part of my research into this move, I found out that California, along with a few other progressive states, will pay my insurance costs in lieu of ADAP through Ryan White.  This assistance also applies to my COBRA premiums for both health insurance and dental insurance.  The premium for both of my insurance policies is a bit over $600 per month; this would be difficult... especially at first when I'd have no income for a couple months.  The information about the insurance assistance program and the required forms were very easy to find.  Even better, when it was time to complete them, they had been drastically simplified. 

Soon after arriving here, I went to the local AIDS services foundation with all the needed information, forms, etc.  I also had to go to the county clinic and apply for Ryan White.  Pending approval, the foundation covered my COBRA payments out of their budget.  I was also offered assistance for housing and food, both of which I didn't need.  There was a bit of running around to one facility or the other, but I was always offered transportation if I needed it (I didn't).  The entire process was fairly smooth and quick, and there was never the option that I wouldn't have meds, any needed treatment, or labs; they simply wouldn't even consider that an option.  I ended up with the option to use a doctor of my choice (I chose a highly rated gay HIV specialist), the pharmacy of my choice, and it still saved the program funds over covering my labs, office visits, and meds.  I do have to re-update / qualify twice a year, but that's also very easy to do. 

Here are my impressions of what I experienced in dealing with relocating and obtaining health overage:

1) the system in CA is flexible; I could get decent treatment and meds directly through the ADAP / Ryan White, or I can continue with or obtain private insurance which would also be covered

2) the system and programs are very easy to navigate; people were helpful, though often overworked, and I never received incorrect information

3) the individuals I dealt with seem to sincerely care about me and my wellbeing

4) there are an abundance of programs offering assistance including housing, food, meds, office visits, counseling, etc

5) there are no waiting lists, unrealistic qualification requirements, or 'cost-containment strategies' that reduce assistance; people simply aren't allowed to do without meds or care as in many other states

6) the programs and system seems to be very progressive and designed to accomplish their mission effectively and humanely

The contrast of what I experienced in CA as a newly-relocated HIV+ gay man compared to what friends and acquaintances have experienced in other (mostly southern states) is amazing.  This was not the scary scenario I'd initially imagined at all.  To the contrary, it was as pleasant and comfortable as I could ever hope that such an experience would be. 

Wow that's so awesome to hear about a positive experience dealing with "the system." 

Hi David. I've moved your thread into the Insurance forum as it is a better fit and where people go when looking for this kind of info.

I'm really happy for you that your move went so smoothly regarding access to health care. It's a pity it isn't like that throughout the country.


Miss Philicia:
Yes, this is basically what I experienced both going from working to not working (but not yet approved for disability as it was pending and/or then approved but there a couple of years wait for Medicare to kick in) in New York state, but also the smooth(-ish) transition from there to Pennsylvania a few years later (basically I moved because the cost of living is less here but still with a lot of medical services).

One tip I would add for those relocating is before actually moving try and meet with a case manager at an ASO in your proposed relocation destination. While they won't set you up with anything until you actually move and prove residence, it's useful to have a conversation that will put your mind at ease because as David states several times, it is very stressful to move when you have HIV because there are so many variables and "what if's" running through your mind, along with the simple normal general stresses of moving.

As far as the COBRA issue and states picking that tab up instead of putting someone on Ryan White -- really it makes sense. Is a $600 monthly premium cheaper for the state than Ryan White, if you consider the worst case scenario like a patient such as me where my monthly tab just for medication (i.e. not even including lab work and doctor visits) is easily $4000/month retail. This is a case of (not to pick on them) southern states not thinking -- they might claim to be fiscally conservative but they actually are not.

I've often thought of where we would relocate when it comes to downsizing. California (Palm Springs) always seemed to be a viable option. It's good to hear that the dreaded transition wasn't dreadful after all.



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