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Author Topic: ADAP and gay marriage  (Read 2189 times)

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Offline m4jj4m

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  • Posts: 10
  • Diagnosed October 2003
ADAP and gay marriage
« on: January 28, 2014, 03:09:13 PM »
My BF/partner and I are celebrating our 10 year anniversary this week and we had hoped to get married.  We live CA, have kept things separate as I am on ADAP.  As one of our last items to check I spoke to my ADAP counselor who told me if my partner and I get married our combined income exceeds the max limit to receive ADAP benefits.  But we don't make enough where we can just pay for my meds which cost around $2K each month.  On top of that our combined income would make Obamacare useless.  Our premiums would be more than double what my COBRA is now. 

So in a nutshell it seems like we can either get married and I may not be able to afford meds or not get married and keep my ADAP.  I've tried reaching out to organizations to see if this info is correct.  No responses back yet.  Does anyone have any insight into this either from first hand experience or know where I can verify this.  It just sucks if this is the case.

Thank you in advance.

Offline bocker3

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Re: ADAP and gay marriage
« Reply #1 on: January 28, 2014, 07:57:44 PM »
Well, it would make sense that if you are married, then your combined income counts towards establishing eligibility (financially).  It's not a "gay marriage" thing - it's a marriage thing.  The same situation would apply to a straight couple.

What about your partner's insurance, assuming he has some -- would he be able to add you to his policy?

Mike
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2013 691/31% <20

Offline tednlou2

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Re: ADAP and gay marriage
« Reply #2 on: January 28, 2014, 11:35:32 PM »
This is something my partner and I have discussed.  If marriage was allowed tomorrow, would we run to get married?  What if I needed help from ADAP?  What about other services?  If marriage was legal, then I would have to be allowed on his insurance.  But, his insurance keeps getting worse.  He pays out so much for his prescriptions, labs, etc. 

So, it is something to consider, if marriage becomes legal in your state or eventually in the entire country.  I wouldn't immediately run out and get married, without going over the financial ramifications.  I mean, especially if your financial situation is precarious.

Offline Ann

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Re: ADAP and gay marriage
« Reply #3 on: January 29, 2014, 05:34:24 AM »
There was a woman who used to post here years ago who was already married and facing a similar dilemma - she and her husband were thinking about getting a divorce just so they could afford her meds. I'm not 100% sure what the outcome was, but IIRC, they got the divorce.

There was another woman who used to post here and she was in a similar bind due to her husband making too much, but at the same time, too little. She ended up committing suicide. Yes, there were other things going on, but a lack of affordable healthcare was top of the list.

This problem has been somewhat common in the US for years in lower income couples from what I understand, and not only for people with hiv. It's been affecting couples with any expensive medical condition.

So much for the alleged sanctity of marriage, eh?



By the way, I've moved this thread into the Insurance and Benefits section as it's to do with ADAP.
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Offline BT65

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Re: ADAP and gay marriage
« Reply #4 on: January 29, 2014, 06:38:46 AM »
At the ASO I work at, when doing paperwork for adap eligibility, we always keep wive's and husband's income separate.  Even if married, we never include both incomes, don't even include the spouse on the application, unless it would give an advantage to the situation.  And we've never been called on it.
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline buginme2

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Re: ADAP and gay marriage
« Reply #5 on: January 29, 2014, 04:41:50 PM »
1.  This isn't a gay marriage issue, its a marriage issue.   The straights have been dealing with stuff like this all along.   It's tough.

2.   Does your partner have insurance?   If so and you get married you can go on his plan.

3.  You say Obamacare  is useless but you don't go into details.   How so?   

4.  I  do understand the frustration somewhat.  I married my partner last year and we had an appointment with an accountant today to go over how or taxes will be affected.   it's a new issue for the gays for sure.
Don't be fancy, just get dancey

Offline mecch

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Re: ADAP and gay marriage
« Reply #6 on: January 29, 2014, 05:13:14 PM »
Affordable Care act monthly premiums are DOUBLE cobra??? 

I thought cobra was super expensive, and I thought I read California has a good variety of ACA offers on the market...

I hope you figure out a way to get married and to afford your health care.

(For what its worth, very few people in the rich countries can afford the retail price of HIV medicine, out of pocket.  --  " But we don't make enough where we can just pay for my meds which cost around $2K each month." -- )
ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

Offline leatherman

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Re: ADAP and gay marriage
« Reply #7 on: January 29, 2014, 10:57:47 PM »
Affordable Care act monthly premiums are DOUBLE cobra??? 
i think that's an apple-to-oranges issue, mecch. the OP says OUR premiums are double MY cobra. It's not really good to compare the premiums a couple pays based on their combined income to what the single person would pay out to Cobra.

On top of that our combined income would make Obamacare useless.  Our premiums would be more than double what my COBRA is now.
Mecch might be onto something else. COBRA is very, very high. if you and your partner might have to pay more than what a person would have to pay on COBRA, you probably should seek out the services of a Marketplace Navigator to help you locate affordable insurance
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline bocker3

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Re: ADAP and gay marriage
« Reply #8 on: January 30, 2014, 08:30:25 AM »
Mecch might be onto something else. COBRA is very, very high. if you and your partner might have to pay more than what a person would have to pay on COBRA, you probably should seek out the services of a Marketplace Navigator to help you locate affordable insurance
COBRA is not uniformly high -- it all depends on what your former employer's plan cost. (If I needed COBRA from my current employer, the cost would be around $175/month - for very good insurance)  Plus -- the difference between a single person's plan cost and a couple's has grown increasingly larger over the years. (currently about 3+ times higher at my employer) So, I do not find it odd that a single person's COBRA costs would be lower than a couples cost under ACA -- especially with little or no subsidy.
Mike
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2013 691/31% <20

Offline leatherman

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Re: ADAP and gay marriage
« Reply #9 on: January 30, 2014, 10:51:02 AM »
the cost would be around $175/month - for very good insurance)
wow. cobra must be state and insurance specific. Two friends of mine (former SC and OH Walmart workers) had to pay out $687 a month to receive similar benefits like their walmart plan. sadly that was about 80% of their monthly income, so like for many poor workers, cobra is an unattainable joke.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Miss Philicia

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Re: ADAP and gay marriage
« Reply #10 on: January 30, 2014, 02:51:06 PM »
$175/mo is less than my Blue Cross cadillac non-HMO plan that I had in 1990. I think that was ~$230/mo

Actually even on disability I pay $203/month in insurance premiums.
"Iíve slept with enough men to know that Iím not gay"

Offline bocker3

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Re: ADAP and gay marriage
« Reply #11 on: January 30, 2014, 04:54:58 PM »
wow. cobra must be state and insurance specific. Two friends of mine (former SC and OH Walmart workers) had to pay out $687 a month to receive similar benefits like their walmart plan. sadly that was about 80% of their monthly income, so like for many poor workers, cobra is an unattainable joke.

COBRA has nothing to do with states.  All it does is allow you to pay for insurance at your former employers full rate (what the employee and the employer pays each month) plus up to a 2% admin fee.  So, it has everything to do with the contract of the employer with the insurance company.

I realize that I made a small calculation error -- my COBRA would be double what I said -- I was using a single paycheck, but I get two of those each month!  Oops -- ~$350/month

Mike
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2013 691/31% <20

Offline buginme2

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Re: ADAP and gay marriage
« Reply #12 on: January 30, 2014, 06:58:43 PM »
COBRA has nothing to do with states.  All it does is allow you to pay for insurance at your former employers full rate (what the employee and the employer pays each month) plus up to a 2% admin fee.  So, it has everything to do with the contract of the employer with the insurance company.

I realize that I made a small calculation error -- my COBRA would be double what I said -- I was using a single paycheck, but I get two of those each month!  Oops -- ~$350/month

Mike

 That's a good deal.   I'm sitting in my office at work right now so I logged on the employee website and it says while I  pay $25 every two weeks for my medical insurance the company pays $257 every two weeks.   So if I got COBRA  that would mean I  would pay $50 ( my monthly share)  plus $514 ( the company's share)  for a total of $564 per month.   Mine is a lot more expensive.


« Last Edit: January 30, 2014, 07:07:35 PM by buginme2 »
Don't be fancy, just get dancey

Offline m4jj4m

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  • Posts: 10
  • Diagnosed October 2003
Re: ADAP and gay marriage
« Reply #13 on: February 07, 2014, 12:46:38 PM »
Thanx for all the replies.  First off I totally shouldn't have lumped ADAP/HIV issues with only gay marriage. 

I spoke to my ADAP counselor and he was gracious enough to look at all ways to deal with this and from what he told me there isn't anyway around it, though I did think in California spouses could file and declare separate incomes.  He told me in CA there was a discussion of raising the max income limit for ADAP but the agency hasn't come to any kind of decision about that.  I also spoke to a social worker friend and she told me the same thing.  Once we are married they base services on combined income. 

I am on COBRA (pretty reasonable at around $389 a month for medical, visual and dental) for another year (when we relocated back to LA, I took a job for a year for the benefits.  I reopened my business here in LA last year) and my boyfriend went through Obamacare for his insurance (the company he works for hired him as a contractor and won't extend benefits) and pays $450 a month just for medical.  When he goes to the dentist he just pays everything out-of-pocket.  If we were to get married our premiums go way up cause he pretty much makes at least 2 times what I make and my income is towards the upper end of the income limit to qualify for ADAP.

Anyways, for now I guess there isn't anything else we can do.  Am glad we didn't do anything until I checked this out.  Alas another thing we need to deal with.  We've already been through alot, including a foreclosure on the first and only home we bought together a couple of years ago, and will make it through this.  It's not like we are breaking up or anything. 

Thanx again for all your input!

 


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