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Main Forums => Living With HIV => Topic started by: Withau on May 16, 2021, 06:09:36 am

Title: Forum Intro + Navigating US healthcare
Post by: Withau on May 16, 2021, 06:09:36 am
Greetings,

I've been living in Europe for 25 years and am approaching retirement age.  I'm getting pressure from family to return to the US, and one of my kids made a great offer for low cost housing in rural Wisconsin.

However,  I am riding an emotional roller coaster trying to navigate the US healthcare system.  I can't figure out what HIV therapy would cost me on Medicare,  and it's overwhelming trying to figure out which plan would be best. 

Currently I only need to have labs done every six months and I pick up a prescription for 3 months of Genvoya and a blood pressure med each quarter.  My total cost per year including everything is 40 euros. My health is good and life is pretty stress free.

Looking at the info I can find online I'm wondering if I am correct to think HIV Meds will cost me about 6000 dollars a year.  In addition it looks like I would have to take what I get - no choice on meds and there might be limited treatment options.

I would be truly grateful if anyone would be willing to share advice or experience on how to "afford" HIV.  I would love to be closer to family,  but returning to the US feels like a dangerous move! I can also use suggestions on the best places to live, or any other topics that come to mind.

Thanks for reading and stay well. 
Title: Re: Forum Intro + Navigating US healthcare
Post by: leatherman on May 16, 2021, 08:52:40 am
In addition it looks like I would have to take what I get - no choice on meds and there might be limited treatment options.
in america? are you joking? every med is available here - as long as there is a payee. the only limit to which meds you take are you, your doctor, and what your insurance formulary will pay for. Formularies almost always cover all but the very most recent meds that have come to market. (Often those newer meds are added within a 6 month period) In 28 year of taking HIV meds (and I use medicare and medicaid) in OH, SC and NC, I've never encountered a limit to treatment options - except in the earliest years when the options themselves were very few.

unless someone from Wisconsin is here and chimes in, you're best bet is to locate the Ryan White HIV clinic nearest where you will be living or the Wisconsin state Ryan white office and speak to one of their representatives. They would be the best choice to help you navigate the Medicare, Ryan White extra help, and medicare Part B Drug insurance plans available in your state.

Looking at the info I can find online I'm wondering if I am correct to think HIV Meds will cost me about 6000 dollars a year.
HIV treatment costs $20-30k a year. Your out-of-pocket cost however would be based on what your insurance will cover and what extra help you might be provided by the Ryan White program (if financially eligible). Definitely talk to someone with Ryan White because unfortunately America's healthcare is a tangled expensive mess
Title: Re: Forum Intro + Navigating US healthcare
Post by: leatherman on May 16, 2021, 08:54:28 am

https://www.dhs.wisconsin.gov/hiv/ryan-white.htm
Title: Re: Forum Intro + Navigating US healthcare
Post by: Withau on May 16, 2021, 11:22:15 am
Hi Leatherman,

Thanks for the info.  The Ryan White tip is very helpful.  I realize that most of the meds are developed in the US, but I was under the impression that Medicare and insurance companies choose what meds they will cover based on cost, etc.  Good to know that that is not necessarily the case. Thanks again.