POZ Community Forums
Meds, Mind, Body & Benefits => Insurance, Benefits Programs & HIV => Topic started by: scottL on December 31, 2010, 01:29:03 pm
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Not sure if it's nationwide, but here in Florida I just saw a poster at the local ADAP center and it says it's changing from 400 % down to 300 %.
I was trying to find out the actual federal poverty level and it appears to be $10,830 or $32,490 for 300 % and a 1 person household.
I got the data from here:
http://www.coverageforall.org/pdf/FHCE_FedPovertyLevel.pdf
Can anyone give an exact number for the requirement for 300 %?
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Ok, I found a good article on this and it does appear the change is from $ 43,320 down to $32,490 for a 1 person household.
http://pozitiveattitudes.com/2010/11/15/adap-medicare-part-d/
It's got good info about patient assistance programs that should get you covered if you make too much money to qualify for ADAP any longer.
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This is state level change for Florida, not anything that applies elsewhere (necessarily). Income thresholds are always state level.
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Can anyone give an exact number for the requirement for 300 %?
$32,490 is the exact amount for 300% FPL
here's a decent chart of FPL% (http://www.scdhec.gov/health/disease/stdhiv/docs/ADAP_2010ADAPSlidingFeeScale.pdf) (that is used to determine SC sliding fees)
and yes, that is the change for just Florida ADAP.
South Carolina's ADAP (and others) has already been at 300% for a long time.
according to the latest ADAP Watch Update (from Dec 10, 2010) (http://www.nastad.org/Docs/Public/InFocus/20101210_ADAP%20Watch%20update%20-%2012.10.10.pdf):
Arkansas lowered financial eligibility to 200% FPL
North Dakota lowered financial eligibility to 300% F
Ohio lowered financial eligibility to 300% FPL
South Carolina lowered financial eligibility to 300% FPL
Utah lowered financial eligibility to 250% FPL
and some cost-containment measures that might be used by Mar 30, 2011 include:
Illinois lower financial eligibility to 350% FPL
Mississippi lower financial eligibility to 200% FPL
New Jersey institute policy that clients between 300% and 500% FPL will only receive antiretrovirals and opportunistic infection medications
by the way the ADAP Watch Update is published twice a month by NASTAD (http://www.nastad.org/) and lists cost-containment changes and current Wait List numbers
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As far as I know, Georgia has always been around the 300% mark. There's always been about a 30k cap on what you can make.
The shit is really beginning to hit the fan with ADAP around here, though. False moves on a patient's part will get them booted off the rolls and onto the infamous waiting list. Failing to make doctor's appointments, pick up prescriptions and renew the paperwork on time every six months - all will get you on the waiting list. The thing is...they've also done away with the so-called Grady Cards that were also used to write down appointments, keep your client numbers and other such info. Now, they just verbally tell you something and it is up to you to write it down and be sure not to miss it - or else.
While this isn't overly challenging to me, I can see that it would be for many of the people receiving services, as a lot of them have transportation, literacy or cognitive issues. It just makes it an awful lot easier to pitfall now.
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I wonder how much "cost containment" this stuff actually contains. I think I read that when New Jersey altered their income cap it shifted, at most, 300 people off of ADAP. And states that make these infamous six month paperwork renewals to kick off people surely must have to then pay for case workers to run around doing extra stuff to get the patient back on. fyi our income % is only 350% so that's just $2000 more than what Florida has switched to. According to this link the cost of living in Miami, which I assume is more expensive than the rest of FL, is lower than what it is in Philadelphia so basically you're still getting a better bargain even with this current ADAP change (and Atlanta really needs to simmer down).
http://www.stlrcga.org/x436.xml
I remember back in the day when I first went on ADAP in New York I never once had to do even a yearly renewal -- from 2001 until I moved five years later I never filled out another forum. I think that's changed there but I don't know. I renew in PA once a year but it's a very easy process.
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In OH after the initial intake, an in-person interview of about 20 mins, with the family services agency running the Ryan White stuff (no ASO in my area), they mailed me a renewal form and I signed it and sent it back once a year. It was waaay easier than the hoops for human services/food stamps that happened once a year. (I mean did they really need to photocopy my bc, ss card, and dl every single year. ::) LOL )
as a tangent to this thought, in OH welfare and food stamps were handled by the same case mgr with one form; here in SC it takes two forms and two case mgrs located in two seperate office bldgs to accomplish the same thing
i remember when greg (and others) started telling us about the 6-mo renewals, and thinking what a waste! It's sad to think how many people might have better access to meds thru FL ADAP if renewals were only once a yr
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I wouldn't praise Ohio too greatly. With over 300 people waiting, it could take years for assistance.
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I wouldn't praise Ohio too greatly. With over 300 people waiting, it could take years for assistance.
but you can get food stamps within 3 hrs, and a welfare check by the start of the next month if you're in need -
all with one application. ;D
Now ADAP, that's another story. ::)
Of course, I guess I should had disclosed that I signed up for RW in the mid 90s and kept renewing with a mail-in form until 2008 ;)
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Yeah, here in Florida you renew eligibility every 6 months. My appointment in December was missed but luckily they called and left me a voicemail the day before my appt stating they had to reschedule it anyway. I didn't hear the voicemail until about 2 weeks after the appointment date had passed. So I probably lucked out on this one, with all the ways they are trying to boot people off. I will certainly never miss an appointment from now on.
Also, I did read a few months back about the fact if you are late picking up your pills you could be subject to being kicked off the rolls.
Funny how all this "tightening up" is coming since the Obama Administration took over. And Bush was being bashed all this time about his indifference to HIV and AIDS.
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Funny how all this "tightening up" is coming since the Obama Administration took over. And Bush was being bashed all this time about his indifference to HIV and AIDS.
And funny how the global economic woes that are at the root of the "tightening up" took root/were created during the Bush era. Obama just inherited it. Kinda like the surplus Bush inherited from Clinton and subsequently squandered.
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I am getting health insurance from my employer in June.
My big issue is the near $200 copay per month for it plus the fact it may cost me another $90 in prescription costs is a hefty (almost) $300 a month that is not something I look forward to paying (it's a damn car note with no new car in return, lol).
I heard there is an assistance program to help with costs from your insurance carrier (premiums + prescription costs I presume). I cannot remember the name of the program, but I know it exists. It's a program specifically tailored to help you transition from ADAP rolls to using your own insurance carrier.
Does anybody know about it and more importantly has anyone ever successfully used it?
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There are several threads on copay (etc) assistance programs in this section of the forums. I know I've read about them before, but I don't know which specific threads. You'll have to have a poke around.
I feel for you, btw. I thank my lucky stars that if I had to end up with something like hiv, that I did so while living in a country with socialised medicine. The NHS sure ain't perfect, but it rocks nonetheless.
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help you transition from ADAP rolls to using your own insurance carrier.
besides providing meds, ADAP itself also pays insurance premiums to help keep people in meds. Here is SC although there is a waiting list, ADAP will still technically enroll people (rather than shunt them to the waiting list) if they have insurance, and pay the premiums.
Then most of the major meds have patient payment assistance programs to help obtain meds or reduce copays (the atripla copay is worth $200 I believe, so most people are co-paying $0 for Atripla. see http://www.atripla.com for more info if that's the med you are on)
if you've been on ADAP and are now going onto insurance, you definitely need to speak to an ADAP/Ryan White case manager about the options. ;)
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Funny how all this "tightening up" is coming since the Obama Administration took over. And Bush was being bashed all this time about his indifference to HIV and AIDS.
Uh, no... that's not how it works. You need to use your head and figure out why things work with ADAP in many other states.
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You need to use your head and figure out why things work with ADAP in many other states.
you see Scott, ADAP is state-administered. It's quite clear to see that the states having ADAP "issues" have decidedly more "conservative" (ie Republican) state legislators which have been reducing (or out and out slashing) funding across the board and in particular to things like ADAP and HIV prevention/education programs. Of course, once a state government underfunds the ADAP program one year then the federal government has to reduce it's matching funds the following year.
In my state, our legislators, despite rallies, phone calls, emails, letters, etc, chose to fund golf tournaments and beauty pageants and underfund ADAP (hell, they wanted to cut the entire ADAP budget, and all HIV prevention funds out altogether), so now even though the amount of HIV infections are rising and we have a waiting list that's growing monthly not only is there not enough money this FY2010 but in FY2011 (which doesn't even start until April) we're already out over 1/2 of what the federal gov't used to provide thanks to the short-sightedness of our legislators.
and heaven help us but even more Republican/Tea Party candidates were elected this last go-round and will shortly be sworn into office. ::) The SC HIV/AIDS Task Force had a Harvard-produced report commissioned that we will be presenting to these new legislators in person, with an accompanying rally, on Feb 9th, that breaks down the HIV/AIDS problems in the state and the best financial solutions. I think though that it's going to be hard to change the attitudes of those with closed-minds here in the Bible Belt, especially when the "big" HIV news out this year can easily be misconstrued, by those who don't care in the first place, into believing that a cure has been found and that there is a med that prevents transmission. I would like to hope that common sense wins out but somehow I think our funding problems for FY2011 are only the tip of the problem that'll be coming along in FY2012.
however, I will say that I still think this problem does spill over into the national scene and should cause concern on all of us to help find solutions. As these fund-cutting states ignore the HIV situation and the rising rates of infection (just look what is happening in DC itself) within their borders, these states will become hot-pockets of a resurgence in the epidemic spilling over into the other states in America.
And Bush was being bashed all this time about his indifference to HIV and AIDS.
Although I have other reasons to dislike the former president, that is not correct. Even though there was criticism of the abstience education portion of the program, actually Bush was highly praised for PEPFAR
"called the largest health initiative ever initiated by one country to address a disease."
http://en.wikipedia.org/wiki/President's_Emergency_Plan_for_AIDS_Relief
"a global AIDS program that has proven to be one of the Bush administration's most successful and popular foreign policy initiatives"
http://www.foxnews.com/story/0,2933,333053,00.html
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Will this change in FPL from 400 down to 300percent be the way they are disenrolling 350 people i wonder? I'm really worried i've been seeing articles all over the internet about Florida disenrolling 350 people already enrolled in ADAP in February. I'm hoping this FPL change is the way they are doing it b/c i'm still below the 300 percent threshold.
Interesting thing ....last year when they implemented the wait list here in florida the flyer they handed out to us when we picked up our meds said they were implementing the waiting list to "protect" those already enrolled in ADAP. .....So much for that!!