74. How can people with HIV and AIDS pay for their medical care?

Care for patients with HIV infection and AIDS is generallypaid for in the same way as other forms of medical care:• by the government (Medicaid, Medicare, and theHIV Uninsured Care Program, which includes the AIDS Drug Assistance Program, known as ADAP); or

• by private insurance companies. Most group health insurance plans cover HIV and AIDS medical treatment, although some have a maximum amount they will cover. People with HIV who are on Medicaid can now choose an HIV Special Needs Plan (SNP). SNPs are special Medicaid Managed Care Plans that allow people with HIV to choose HIV specialists as their primary care doctors and give patients access to special services.

The New York State Medicaid Program pays for drugs for persons on Medicaid. In addition, the New York State Department of Health operates the HIV Uninsured Care Program, including ADAP, which offers free drugs, primary care, and home care for people who do not qualify for Medicaid and who meet income requirements. ADAP can help people with no insurance or partial insurance. The program includes these services:

• ADAP pays for medicines for the treatment of HIV- and AIDS-related conditions.

• ADAP Plus (Primary Care) pays for primary care services at participating clinics and hospital outpatient programs, drug treatment programs, and private doctors’ offices.

• The HIV Home Care Program pays for a person’s home care services that are identified by their doctor. The maximum lifetime Home Care benefit per person is $30,000.

• APIC (ADAP Plus Insurance Continuation) pays for the health insurance of people with HIV who meet certain income and insurance criteria.

• AHIP (AIDS Health Insurance Program), operated by Medicaid, also pays for the health insurance of people with HIV who meet certain employment, income, and insurance criteria. But the criteria are slightly different from those of the APIC program. People who do not qualify for AHIP may qualify for APIC.