Saturday, December 31, 2011

Save Money on your HIV medications in 2012

I remember when I was diagnosed, it was March 3rd 2010. I was working full time and had great benefits. I was rarely sick, and barely used my health insurance. My deductible I must meet before my medication is paid for at 100 percent is $1,800. When I was told I was HIV positive I chose to begin Anti-retroviral medications (ART) immediately. When I went to the pharmacy to fill my scripts I owed 1400.00 on this day, just to get my medication.  Living in NYC I had all I could do to save for my rent, eat, and occasionally have some fun with friends. My taxes were also due, and to anyone who lives on a shoestring budget in NYC every penny in your paycheck counts. So I always owed money at tax time, and that year I owed 600 dollars.
 I went home in tears from the pharmacy; knowing my VL was very high at the time and CD4 was low.  I wanted to begin suppressing this virus, but I couldn’t afford to. I did some research online and found co pay assistance programs which picked up a portion of the cost of my meds; I printed the coupons out and went back to the pharmacy that very same day. With copay assistance my medications came down to around 600 dollars for my Truvada/Isentress combo.  So, now the decision was to send in my money saved for my taxes or pay for my HIV medication.  To me the decision was simple.  I got my meds, and didn’t pay my taxes on time that year.
In the meantime my ADAP (AIDS Drug Assistance Program) application was pending approval.  Thankfully the next month, my ADAP application was approved and since then I have had no out of pocket expense for my HIV medication.  The one thing that always went through my mind with HIV is that I knew it was an expensive illness to treat, and how would I ever be able to afford the medications should I become positive.

The thought of not being able to pay for HIV medications should not be a deterrent in getting tested. Resources exist to make your medications free or at a reduced cost.  Please see some tips and resources below.  
Tip 1) if you are diagnosed with HIV and have private health insurance, you may ALSO qualify for your states ADAP program, as well as copay and patient assistance programs (PAPS) Simply Google your states health department and ADAP and you can look up eligibility requirements for ADAP.  Having private insurance and ADAP will give fill in the gaps. What your private insurance may not pick up, ADAP may and vice versa.  You can apply for ADAP on your own, but my suggestions would be finding an AIDS services organization (ASO) near you that can help you through the process.
Tip 2) if you have no health insurance you will likely qualify for your states ADAP program and other services, making your medication free! Find the nearest ASO (AIDS Services Organization) to start the paperwork process. Case managers will guide you through the process.  Some ADAP programs include other medications at no cost such as blood pressure meds, psychiatry medications (anti-anxiety/depression) meds, as well as other medications.  You can ask or find on the internet a list of what medications your states ADAP covers.
Right now across 10 states over 4,000 people are on ADAP waitlists. (see list).  So for those with no private insurance, and who would normally rely on their states ADAP program, funding does not exist in these states, and so therefore Patient Assistance Programs (PAPs) have been set up by the various pharmaceutical companies.
What are PAPs?
Patient Assistance Programs (PAPs) offer free HIV drugs to people with low-incomes who do not qualify for any other insurance or assistance programs, such as Medicaid or AIDS Drug Assistance Programs (ADAPs).
What are Co Pay programs?
These programs offer assistance to people with private health insurance for the co-payments required to obtain HIV drugs at the pharmacy. Some companies offer co-pay assistance for all of their drugs, including non-HIV drugs.
For further information on the above programs including eligibility criteria, pharmaceutical company names, and drugs covered I have included the direct link on where you can find this information and save money on your medications.

The most commonly prescribed medications today are, Truvada, Isentress, and Atripla, Click on the drug name and it will take you to that drug co pay assistance program. For PAPs see the more detailed info in the AIDSmeds link above.

Again, thinking you cannot afford your medications should you become HIV positive and or infected with Hepatitis C should not be a deterrent to getting tested. As noted above, resources exist to help you pay for the medications which will keep you alive and healthy.
In 2012 I ask you add one more resolution to your list; getting tested for HIV and sexually transmitted Hepatitis C!
I wish you happiness and good health in the coming year.
Happy New Year!
Kevin Maloney
Dual Diagnosed March 3rd 2010, treated and cured hepatitis C; HIV undetectable and VL 480
“Rising Up, standing out, and speaking up about HIV/AIDS and Hepatitis C”

If newly diagnosed you may also be interested this blog entry I created:
10 tips for those who are newly diagnosed


  1. Sharing... Sharing... Sharing!!! :)

  2. Good afternoon my partner was diagnosed w HIV, and Neuro Syphilis just last week and started on medications via picc line for the Neuro syphilis and Truvada and Sustiva for the HIV, since then we have learned that our deductible for rx is 5,000, and the cost for the medications monthly will be 1,700 this came as a complete surprise since the case manager at the hospital completely failed to mention that to us upon discharge, now we have the option of medications or a place to live? Pretty tough huh? I find it ironic that we have dedicated our lives to taking care of others and now we cannot even take care of ourselves? As nurses we are taught to be empathetic, caring, and a voice for those which have no voice? but who advocates for us the workers of this great nation, my partner cared for his mother at the age of 17 while she wasted away of cancer, 7 years later he cared for his grandmother while she was dying of septicemia, 10 years after his mom succumbed to cancer his grandfather did as well. Since then he has endured his troubles on his own, putting himself through nursing school with the love and support of close friends, I met him a year and a half ago and fell in love with him the minute I laid eyes on him I remember saying to myself “that’s my future husband” we have had are ups and downs but were finally getting it all together when he started complaining about his eyesight after several bum diagnosis’s (blood clot, MS, diabetes) he was diagnosed w Neuro Syphilis, and then later in the hospital w HIV. I was tested two days ago and am negative for both syphilis and HIV. We are now faced w financing my partner’s life essentially. The costs of his medications are staggering and the programs available only help or aid those w no insurance or those w little to no income. What if anything can I do?


RiseUpToHIV Daily News Digest