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Author Topic: Moving from Greece to the US  (Read 1186 times)

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Offline nikos

  • Member
  • Posts: 3
Moving from Greece to the US
« on: October 09, 2018, 02:30:12 pm »
Hello everyone,

I'm a Greek citizen living in Greece. I recently received a job offer from a big IT company in Pittsburgh. However there a few things I'm concerned with about migrating and living with HIV in the US. I have read a lot about insurance but I'm still not sure how that works in the US. You see in Greece everyone is entitled with free HIV meds irrespective of whether he's insured or not. The company offers insurance so I guess I will be insured by my employer. Does this suffice to cover my health expenses regarding HIV? Are there specific things I have to check in my insurance plan? And if so, do I need to disclose to my employer that I have HIV in order to offer me an appropriate insurance plan because I'd rather do that.

Then, upon arrival in the US, I guess I need to find a doctor to do my lab tests and prescribe me the medication. Currently I'm on Eviplera (I think the name is Complera in the US). Are there specific doctors, clinics or hospitals that treat HIV or I should find any private doctor based on recommendation?

Finally, another thing that concerns me has to do with me applying for a working visa to work in the US. As far as I read, HIV is not a reason to be denied a visa and you don't need to disclose that in the visa application. 

 

Offline MadDog125

  • Member
  • Posts: 59
  • Not today,
Re: Moving from Greece to the US
« Reply #1 on: October 11, 2018, 12:16:43 am »
I don't pretend to know the visa system or immigration.  Or how that would work status wise.

I do know a bit of what goes on insurance wise.  Your employer and insurance are totally separate entities.  Your employer offers insurance but you have to opt. In.  Your employer will not automaticly set you up.  For my company open enrollment is when you are first hired with re enrollment every january.  For me it's easy I check a form letting them know I'm not making any changes and that's it.  I can't speak for your company but most have an employee contribution.  For me 95$ a month. That contribution is usually deducted automatically from your paycheck prior to taxation, (bonus less of your income is taxed). 

Under the ACA (obamacare) law at least two drugs in each class must be covered by your insurance.  Also you can not be denied coverage due to being HIV+.

Most insurance has co-pays on doctor visits and perscriptions.  In my case it's 35$ for doctor visits and about 150$ for my rounds of blood work.  I pay nothing out of pocket for my drugs.  Yours could be different and some companies offer as benefits full co pay or deductible cost coverage, my X had such benefits.  Medical, dental, and vision zero out of pocket cost.

A word on legality.  Medical records are seriously guarded things in the US.  I had to sign release forms so my flight surgeon could see my records from the infectious disease Doc.  You are under no obligation to disclose your status to your company.  They can and will only ask if you have any medical condition that would limit your ability to do the job. 

The only exceptions to this I have heard of are for medical personele.

A word of caution, the US is a big country laws vary a lot state to state on HIV.  I live in maryland and here while your employer has zero right to your medical records it is a crime to not disclose your status to a sex partner. 
DX 28DEC17, cd4 112, VC 63000
13FEB18, cd4 215, VC 156
14MAY18, cd4 260, VC 31
23AUG18, cd4 298, VC 61
03OCT18, cd4 300, VC 35
21NOV18, cd4 259, VC <20
18JAN19, cd4 284, VC 24

Offline nikos

  • Member
  • Posts: 3
Re: Moving from Greece to the US
« Reply #2 on: October 17, 2018, 01:55:01 pm »
Thank you much all!! That was really helpful!! Also very helpful the advice that I don't need to disclose my status to my employer. I was a bit anxious about that.

So as far I understand I would have to check the amount of co-pays and ensure that they are not too high especially for prescriptions. Then, once I'm insured I just have to find a doctor in the US to treat me. Doesn't sound very complicated! :)                                                     

Offline MadDog125

  • Member
  • Posts: 59
  • Not today,
Re: Moving from Greece to the US
« Reply #3 on: October 17, 2018, 11:13:33 pm »
I doubt it would be more than 50$ a month.  Plus Gilead and Viiv the companies that make tivicay and descovy the drugs I'm on have co pay programs.  I just looked up the details essentially even if you had a 100$ a month co pay the drug manufacturer would cover it.  In other words with decent insurance you would have no out of pocket cost for your drugs.

Again this can vary big time case by case.  My benefits aren't considered that good generally speaking.  Yet my total out of pocket cost for hiv treatment is about 70$ a month total, and I'm still seeing the doctor and getting bloodwork every three months.  Plenty of my Co workers have higher cell phone bills.
DX 28DEC17, cd4 112, VC 63000
13FEB18, cd4 215, VC 156
14MAY18, cd4 260, VC 31
23AUG18, cd4 298, VC 61
03OCT18, cd4 300, VC 35
21NOV18, cd4 259, VC <20
18JAN19, cd4 284, VC 24

Offline pittman

  • Member
  • Posts: 284
Re: Moving from Greece to the US
« Reply #4 on: December 29, 2018, 10:28:41 pm »
Don't frequent this forums as often, but saw this and thought I'd reply. If you took the position in Pittsburgh, then welcome! I am also in Pittsburgh.

The primary center in Pittsburgh that specializes in HIV is part of the University of Pittsburgh Medial Center. They have been great and offer a full range of services.

https://www.upmc.com/services/division-infectious-diseases/services/pittsburgh-aids-treatment-center

In the Pittsburgh area, it is a bit of a monopoly when it comes to healthcare, and you generally should make sure that the health insurance options offered by your employer have one that includes this clinic.  Most plans will allow you to look up the doctors prior to signing up.  You can also call the clinic to make sure. Highmark health plans will NOT cover this clinic due to a local dispute between the hospital and that particular insurance company.

MadDog125 answered your other questions and just for another point of reference, I have what is called a High-Deductable Plan.  With that plan you pay the entire first $1200 each year, and a portion there after until you hit the maximum out of pocket limit that you are expected to pay, which is about $2,500 each year. After that, the insurance covers everything else until the end of the year. Add to that what I pay for the plan itself and I pay about $3,600 each year towards my healthcare.

Except, as Maddog also pointed out, many of the drug companies also offer co-pay cards. By using those, I managed to cover my entire out of pocket costs by just scheduling my semi-annual doctor visits to June/July and November/December. With the prescriptions being paid for in the first half of the year, that covers my portion. (Of course, I am still paying for my plan itself...)

Some plans are better that others, but regardless, look into the co-pay cards.

Offline Expat1

  • Member
  • Posts: 188
Re: Moving from Greece to the US
« Reply #5 on: January 01, 2019, 08:24:19 pm »
There are also CoPay cards that can help with deductable and copays.

For the med you described look here:
https://www.gileadadvancingaccess.com/copay-coupon-card

Offline nikos

  • Member
  • Posts: 3
Re: Moving from Greece to the US
« Reply #6 on: March 10, 2019, 10:11:17 am »
Thank you for all the info! Really appreciate it! Health insurance is much different in my country so I'm really stressed about this procedure. All this information you provide really helps me learn the basics.

My company offers me 2-3 different plans that I can choose from (Shared Deductible Plan, Health Savings Plan, In-network only plan) and I can choose between two networks: Aetna and Premera Blue Cross.

@pittman: This clinic seems a good choice so I have to check that it will be in the network I choose, right?  Also,  I'm currently on Eviplera (I think the name of this drug is Complera in the US) so I guess I have to check that this drug is covered by the provider I choose, right?

I was wondering if there is any service that can help me choose the best plan for my case, as I would prefer not to disclose my HIV status to my employer.

Offline pittman

  • Member
  • Posts: 284
Re: Moving from Greece to the US
« Reply #7 on: March 10, 2019, 03:04:26 pm »
So are you moving to Pittsburgh for sure then?

Aenta insurance is accepted by the main HIV clink I previously posted the link for.  It is also the insurance company I use. 

You should not have an issue getting your current drug covered, but a call to the insurance company or a visit to their site should confirm.

So here are a few other things to learn about U.S. Healthcare:
1) People who area on expensive, on going maintenance drugs will generally be required by the insurance company to use a particular specialty mail order pharmacy.  You will then be shipped 90 days worth of drugs at a time. Sometimes they can ship to a local pharmacy if you prefer that. I get mine from CVS Specialty Care. The upside, is that the pharmacists they have covering these customers generally have more specialized education for the particular conditions like HIV. 

2) You will usually select the insurance plan and company after you start. Bring at least month supply of your current medication if you can to just give you the time to get set up here.

The terms you will need to understand:
1) employee contribution
This is the portion deducted out of each paycheck. It is taken out regardless of actual use.
2) deductible
The U.S. insurance system expects individuals to pay some of the costs (above your employee contributions) related to actual use. Many plans expect you to pay for everything up until you have paid the full deductible amount. After that point, the insurance company starts paying. Some exceptions:
- services deemed "preventative" are generally covered without additional charges.
-*if* your plan has co-pays, then you pay just the co-pay for the particular service.
- Drug Co-Pay cards, (link was provided in earlier post) will pay your costs for the drug.  In most cases that still counts towards your deductible.
3) copay
A fixed fee for a particular service that the customer pays. (example: $20 for a prescription refill.). These count towards your deductible.
4) co-insurence
No all plans have this, but the idea is you pay something like 20% of the treatment costs and the insurance company pays 80%.  The 20% you pay does count towards deductibles.
5) max out of pocket
This is the maximum money that the customer is expected to pay for in a year. In general, after you have paid a cumulative amount in deductibles, co-pays and/or co-insurance, then the insurance company pays everything from that point on. 

Again, a strategy for keeping your personal costs down, use the drug co-pay at least twice in the first part of the year. For me, that covers all the way to the out of pocket amount. 


 


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