Women & HIV/AIDS

Financial Help

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• Disability Benefits for People Who Cannot Work
• Medicare & Medicaid for Working People With Disabilities
• Medicaid
• Ryan White HIV/AIDS Program
• Programs That Help Pay for HIV/AIDS Medicines
• Housing Opportunities for Persons With AIDS (HOPWA)
• Additional Resources

Paying for everyday needs and health care is hard for many people. Having HIV/AIDS can be extra costly. HIV/AIDS drugs are expensive, and many people find it hard to buy the medicines they need. Some people with HIV/AIDS are not able to work. Other people may have problems getting the housing they need. Services are available to help people with HIV/AIDS pay for health care, drugs, housing, and even basic needs.

Disability Benefits for People Who Cannot Work

If you have HIV/AIDS and cannot work, you may qualify for disability benefits from the Social Security Administration. Your disability must be expected to last at least a year or end in death and be serious enough to keep you from working. The money you get can help you pay for basic needs, such as food, clothing, and shelter. Benefits are paid under two programs:

• The Social Security Disability Insurance Program is for people who have worked and paid Social Security taxes. The amount of money you get each month depends on how much you earned while you were working. You also will qualify for Medicare after you have been getting disability benefits for 24 months. Medicare is a federal health insurance program. It helps pay for medical care, HIV drugs, and other services.
• The Supplemental Security Income (SSI) program is for people who have little income and few resources. If you get SSI, you most likely will be able to get food stamps and Medicaid too.

If your Social Security benefits are very low and you have limited other income and resources, you may qualify for both programs.

Medicare & Medicaid for Working People With Disabilities

Special rules make it possible for people with disabilities receiving Social Security benefits or Supplemental Security Income (SSI) to work and still receive monthly payments and Medicare or Medicaid. Social Security calls these rules work incentives. Contact your state Social Security office to find out if you can make use of these work incentive programs.

Medicaid

Medicaid is a federally sponsored health program for people with low income. Each state runs its own Medicaid program. Medicaid does not pay money to you; instead, it sends payments directly to your health care providers. You must qualify to get Medicaid. Most adults with HIV disease who qualify for Medicaid:

• Are disabled
• Have low income
• Have limited assets
• Have families with dependent children and meet certain income and resource standards

Medicaid takes care of your medical bills while you are in the hospital or receiving outpatient care. In some states, Medicaid pays for hospice care, a private nurse, and case management. Currently, all states cover FDA-approved prescription drugs, including various HIV/AIDS drugs. Also, some states have special waiver and demonstration programs to help certain populations, like people with HIV/AIDS.

Whether you can get Medicaid will depend on the state where you live. Each state has different rules on who can get into the program. You apply to Medicaid in the state where you live. You can get an application at your local Medicaid office. The phone number for your local office can be found in the blue pages of your phone book. A lot of times, the number is under "medical assistance." If you have trouble finding the local Medicaid office phone number in your phone book, call your local Social Security office. They can give you the phone number and address of your local Medicaid office.

Here are some special features of Medicaid that may also help you:

Financial Support During Pregnancy

If you are pregnant, Medicaid may pay for your prenatal care. If you are pregnant and HIV-positive, Medicaid might pay for counseling, medicine to lower the risk of passing HIV to your baby, and treatment for HIV. You can stay on Medicaid for about 90 days after you deliver your baby. It may continue for one year after you deliver your baby. This depends on the rules in your state. Each state makes its own Medicaid rules. If you don't think you qualify for Medicaid, check again. You may be able to get it while pregnant because the income limits are raised for pregnant women in all states to provide prenatal care and HIV treatment.

Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)

The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) service is Medicaid's comprehensive and preventive child health program for people younger than 21. EPSDT offers Medicaid-eligible individuals under age 21 access to Medicaid services that are medically reasonable and necessary even if the service is not covered under the States' Medicaid plan for the rest of the Medicaid population.

Ryan White HIV/AIDS Program

This federal program helps people with HIV/AIDS who have nowhere else to turn for the care they need. It funds outpatient primary care, HIV/AIDS drugs, and supportive services for people with HIV/AIDS who have income too low to pay for care or have no health insurance or not enough insurance to pay for the care they need. In some cases, family members can receive services through a Ryan White program focused on women, infants, children, and youth, even though they are not diagnosed with HIV. Call your state’s HIV/AIDS hotline to ask about care through Ryan White or other programs.

Programs That Help Pay for HIV/AIDS Medicines

You can get help paying for HIV/AIDS drug treatment:

• Ryan White AIDS Drug Assistance Program (ADAP) provides HIV drugs to people with HIV/AIDS who don't have health insurance or have private health insurance that doesn't pay for the drugs. For example, it covers people with low incomes who may not be disabled and can't get public health insurance, like Medicaid. This drug program is run by your state and may have different rules than other states. Unfortunately, many states don't have enough money to help everyone who applies. Call your state’s HIV/AIDS hotline to ask about the ADAP program in your state.
• Patient assistance programs are offered by some drug companies to give medicines at a lower cost or for free to people who can't afford them. Ask your doctor to contact the program for you.
• Clinical trials offer people with HIV a way to try new HIV medicines that aren't yet available to the public. AIDS clinical trials are research studies in which new treatments for AIDS and HIV infection are tested in humans. These studies help determine if the drugs are useful and safe in treating HIV disease. These HIV drugs are free for the person in the trial. See the Research and Clinical Trials section for more information about clinical trials.

Housing Opportunities for Persons With AIDS (HOPWA)

The U.S. Department of Housing and Urban Development (HUD), Office of HIV/AIDS Housing runs the Housing Opportunities for Persons with AIDS (HOPWA) program. Their programs provide HIV/AIDS housing that includes short- and long-term rental assistance, live-in medical facilities, and housing sites developed just for people living with AIDS.

Additional Resources:

Publications

1.   Housing Opportunities for Persons with AIDS (HOPWA) — HOPWA was created by the U.S. Department of Housing and Urban Development to provide housing assistance and related supportive services to people with HIV/AIDS and their families.

   http://www.hud.gov/offices/cpd/aidshousing/programs/index.cfm

2.   Medicaid Buy-In For Working People With Disabilities — States can extend Medicaid coverage to certain disabled people who work. This fact sheet explains more about the program and who qualifies.

   http://www.socialsecurity.gov/disabilityresearch/wi/buyin.htm

3.   Social Security For People Living With HIV/AIDS — If you have HIV/AIDS and cannot work, you may qualify for disability benefits from the Social Security Administration. This publication provides information about how to qualify and file for the benefits.

   http://www.ssa.gov/pubs/10019.html

4.   What You Need To Know When You Get Disability Benefits — This online booklet explains some of your rights and responsibilities when you receive disability benefits from Social Security. It provides information on reporting changes that could affect your benefits, reviewing your medical condition, and returning to work.

   http://www.ssa.gov/pubs/10153.html

5. Patient Assistance Programs (Copyright © ATDN) — This online resource offers information on government and drug company-sponsored programs that help pay for HIV medicines.

   http://www.atdn.org/access/pa.html

6. State HIV/AIDS Program Directory (Copyright © NASTAD) — This list from the National Alliance of State and Territorial AIDS Directors provides contact information for various HIV/AIDS-related programs in your state.

   http://www.nastad.org/About/res_state_Directory.aspx

Organizations

1.   Center for Medicare and Medicaid Services, HHS
2.   HIV/AIDS Bureau, HRSA, HHS
3.   Office of HIV/AIDS Housing, Community Planning and Development, HUD
4.   Social Security Administration Online
5.   TARGET Center for the Ryan White CARE Act HIV/AIDS Program
6. National AIDS Fund
7. Project Inform

= Indicates Federal Resources

Content last updated March 4, 2009.