Under-utilized program can help HIV-positive maintain insurance

Under-utilized program can help HIV-positive maintain insurance

Posted on 07 May 2009 at 3:52pm
By Renee Baker Contributing Writer

Resource Center of Dallas helps those who lose their jobs make often-expensive COBRA payments that keep insurance in place

Craig Hess

In June of 2008, “Maria Johnson” found herself on unpaid medical leave of absence, HIV positive, and six months pregnant.With no income, she could not afford to pay the costly health insurance premiums that would cover medical care and the prescription HIV medications that would protect both her and her unborn child.

So the 28-year-old Johnson turned to the Resource Center of Dallas for help, said Bret Camp, RCD’s associate executive director of health and medical services.

Thanks to their Ryan White Insurance Assistance Program, Camp said, Johnson was able to keep her private health insurance, which provided her with the anti-viral medication needed to protect her baby boy, who has tested HIV negative since his birth last September.

But many unemployed or underemployed HIV-positive workers don’t find help because they are unaware of RCD’s Insurance Assistance Program, Camp said.

The IAP, which is funded through the Ryan White Planning Council of Dallas, provides financial assistance by paying health insurance premiums and prescription medication co-payments, he explained. Medication costs for HIV treatment remain high, and state-of-the-art medicines can cost as much as $1,400 per month.

“It is not unusual,” Camp said, “to see co-payments as high as $300 a month.”

Bret Camp

Camp said there are 15,000 people in Dallas County living with HIV, yet only 9,000 of them are utilizing services at the various health agencies in the county. This leaves 6,000 that are in either in private care or not seeking health services at any location.

He said more people need to be aware of the program because so many are losing their private health insurance and falling into public health care systems, which cost Dallas County millions of dollars each year. And the cost for the insurance premiums is much less than the costs accrued when clients are enrolled in overcrowded public healthcare systems.

Although the Resource Center’s mission is to provide support to the North Texas LGBT community, anyone who is HIV positive may apply for the IAP program, Camp said. According to Client Services Manager Bethany Kramer, RCD currently serves 2,311 clients, with approximately 40 percent identifying as straight.

The IAP does limit participation to those who earn no more than three times the federal poverty level after medical expenses are backed out. And assistance is also limited to a maximum of $750 per month.

About 400 individuals are currently enrolled in the IAP, though Camp believes this number would be higher if the program were fully utilized.

Craig Hess, insurance assistance coordinator at RCD, said for those recently laid off, the timing of getting enrolled in the IAP is critical.

Laid-off employees are generally allowed to continue their health insurance through the 1985 COBRA Act, Hess noted, but they must pay for the insurance premiums themselves — and they must enroll in the first few months.

The problem is, Hess said, the COBRA payments are often untenable. And if premiums are not paid before insurance coverage runs out, the client’s HIV status will be earmarked as a “preexisting condition” when they reapply for insurance in the future.

Discrimination against those with HIV is yet another concern. Hess said that a number of Resource Center clients report being laid off because employers deemed their health care costs as unacceptable, and insurance companies may discriminate as well.

“Insurance companies can’t cancel your coverage for having HIV, but they can raise your rates,” Hess noted.

He recommended that anyone who suspects they may have been discriminated against because they are HIV-positive contact the Legal Hospice of Texas.

The Ryan White Insurance Assistance Program is available through the Resource Center for those living in the seven-county area including Dallas, Ellis, Henderson, Navarro, Grayson, Fannin and Cooke counties.

For more information, contact Craig Hess through the Resource Center Web site at www.rcdallas.org.  For those in the Greater Tarrant County area, the IAP is available through the AIDS Outreach Center at www.aoc.org.

Renee Baker is a licensed massage therapist and transgender diversity consultant and may be reached on her Web site, www.renee-baker.com.

This article appeared in the Dallas Voice print edition May 8, 2009.

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