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Medicare Coverage for HIV/AIDS Treatment

medicare benefits for hiv/aids patients

Medicare HIV Treatment and Medicare AIDS Treatment Coverage: What Benefits Are There for HIV/AIDS Patients?

If you’re living with HIV infection in the United States, know that Medicare plans offer coverage for HIV treatment. Call our licensed agents today at (800) 950-0608 to find plans that offer the coverage you need for HIV treatment.

Just the Essentials:

  • HIV treatment is an important aspect of LGBTQ+ healthcare, especially for those reaching senior age today.

  • Original Medicare (Parts A and B) and Medicare Advantage plans cover HIV and AIDS treatment.

  • Medicare Part D Prescription Drug coverage plans are legally required to cover medications required for treatment of HIV and treatment of AIDS.

  • Medicare Advantage and Medigap Supplemental plans can help you cover aspects of HIV treatment that Original Medicare does not.

A Number of Seniors May Be Living With HIV

HIV is an incredibly serious virus that can directly affect the immune system. Discovered in 1981 after a Los Angeles immunologist reported rare, unknown fatal lung infections in five relatively healthy young men, it was seen as a death sentence at one time for anyone who caught it.

However, thanks to breakthroughs in medication and medical technology, HIV is no longer as feared as it once was. These days, HIV and AIDS treatment is more advanced and can help you live longer, healthier lives if you live with the illness. Health care provider treatment is not a cure, but it can help you manage the disease much more easily than before.

With that said, finding a health care provider that offers great treatment can be relatively expensive. If you’re a senior living with the illness and on a fixed income, you may fear that you have no way to pay for the treatment you need. Fortunately, the right Medicare formulary  can help you cover the expenses that come with your much-needed treatments and services.

medicare benefits for hiv patients

HIV - A Brief Primer

Human Immunodeficiency Virus (HIV) attacks the cells that help your body fight off infection and illness. The virus was not well-known to many American citizens or health care providers until the early 1980s, when five young, healthy men in California passed away after catching an unknown lung infection. The illness, which later became known as AIDS, would initially be found primarily in LGBTQ+ individuals. This led the illness to be wrongly and derogatively labeled by many as “gay cancer” or “gay man’s pneumonia”. As the decades would progress, numerous individuals identifying as heterosexual would catch the HIV or AIDS virus, showing may health care provider researchers – and the community at large – that it isn’t a community-specific disease.

AIDS, medical researchers would come to find, is a terminal late-stage progression of what would become known as HIV. It was discovered that the virus is transmitted solely by coming into direct contact with bodily fluids left behind by an individual diagnosed with HIV that has a detectable viral load. While it is primarily passed on through unprotected sexual activity, it can also be passed on through intravenous drug use or by other means.

The HIV virus is primarily transferred through:

  • Blood
  • Seminal fluid/pre-seminal fluid
  • Rectal fluids
  • Vaginal fluids
  • Breast milk

Because of the fear and stigma that surround the HIV virus, it’s a common belief that the virus can be contracted by simply touching any of the above. This is not true. In order for transmission of the virus to occur, it must reach your bloodstream through:

  • A mucous membrane.
  • Open cuts or sores.
  • Direct injection from a needle or syringe.

HIV Treatment and Treatment for AIDS: Can HIV Be Cured?

HIV is a virus that the body cannot rid itself of, and there is currently no known cure. HIV is a lifelong illness that can harbor many negative effects (especially on the immune system), but thanks to regular developments in HIV medicine, it can be managed, especially if it’s caught early. Modern treatments and HIV medicine can render an undetectable viral load, which means that an active viral load cannot be found in the blood through a lab test. 

So, for now, the answer is that the HIV virus unfortunately cannot be cured. However, you can live a long, healthy, and fulfilling life with the virus with proper treatment. Many of today’s LGBTQ+ seniors who contracted the illness in the 1980s and 1990s have survived and thrived today as a result of HIV treatment and HIV medicine.

hiv/aids medicare benefits

Medicare AIDS Treatment: Does Medicare Cover HIV/AIDS Treatment?

If you’re a senior currently living with HIV, or the virus has made the progression to AIDS in your system, you may be wondering one thing. “Does Medicare cover HIV AIDS treatment?”

The answer is “yes”: your HIV or AIDS treatment will be covered by your Medicare plan formulary. CMS also offers a library of online resources for seniors who are dealing with HIV and AIDS. All Medicare plans offer coverage for:

  • Preventive services and screenings that lead to the detection of the HIV virus
  • Hospitalization for HIV and AIDS treatment
  • HIV medicine and other supplies needed for HIV treatment
  • Medications and supplies needed for treatment of AIDS
  • Medications to prevent the transmission of HIV (such as PrEP)
  • Mental health counseling during your HIV and AIDS treatment

AIDS treatment under Medicare typically includes:

  • Short-term inpatient care at skilled nursing facilities
  • Home health care (on a limited scale)
  • Hospice care at the end of one’s life

Original Medicare, Medicare Part A and Medicare Part B, provides Medicare AIDS and HIV treatment coverage for all of the above. However, it may not cover the cost of certain things, such as prescription medications* or various forms of antiretroviral therapy. 

Medicare Advantage plans offered by private insurance companies offer the same coverage provided for HIV treatment that Original Medicare offers. However, in many cases, it offers extra benefits** that can help you cover the costs of care for HIV and AIDS.

If you need assistance covering costs for prescription medications, copays, or coinsurance related to treatment of HIV and AIDS, Medicare Part D Prescription Drug coverage plans and Medigap supplemental insurance can help. You may find a variety of plans in your area that will reduce your burden of out-of-pocket costs for HIV treatment.

*Medicare Part A will cover medications or therapies needed for HIV and AIDS treatment during hospitalization. Medicare Part B will cover medications that need to be administered by your health care provider at an outpatient facility.

**Medicare Special Needs Plans (SNPs) are special Medicare Advantage plans that offer extra benefits for individuals living with chronic illnesses. If you’re living with HIV and you’re eligible for Medicare, you may qualify for an SNP.

medicare hiv patient benefits

Treatment for HIV: Seniors Living With HIV Can Continue to Lead Healthy Lives

Thankfully, we no longer live in a time where contracting HIV means certain death. If you’re a senior who has lived with HIV for some time, you probably already know that proper treatment and self-care, as well as access to the right health care provider, can help you lead a longer, healthier life. If you’re a senior who has only recently contracted the virus, modern treatment will give you a fighting chance at life.

If you’re living with HIV or AIDS and are in need of health coverage, there are Medicare plans that can meet your needs. Give our experienced, licensed agents a call today to learn about Medicare plans that are available in your area.

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