Last week someone called my office and said he was afraid he’d been exposed to HIV and asked if we could help with the cost of HIV Post-Exposure Prophylaxis (PEP), medication to prevent HIV infection after exposure and costing about $3,000 for the one-month supply needed. This person had gotten drunk and had unprotected sex with a person he felt was at high risk for HIV. He had gone to the emergency room to get a prescription for antiretroviral medications, the medications used for PEP. He had the prescription, but he had no insurance. The answer I had to give was no; there are no publically-funded programs to provide PEP. Can you imagine how many people would be in my office everyday to get PEP if there were?
So, I did the only things I could do for him.
I offered a free HIV test that day and two more over the next few months to make sure he had not gotten infected. I offered him condoms and information about Pre-Exposure Prophylaxis (PrEP). He told me that he and his mother were going to pay the money to get his PEP medications and also pay the emergency room fee, another $500. And then I offered the one other thing I could do for him, I gave him information about how to get health insurance.
It turned out that he was absolutely eligible for free health insurance. If he had had health insurance, his insurance would have covered the cost of his PEP and his emergency room visit.
Better yet, he would have even been able to get on PrEP, because his health insurance would have paid for that too, about $1,500 a month.
We are now in the second year of implementation of the Affordable Care Act (ACA), and it’s unbelievable how many people are still walking around perfectly eligible for free health insurance, but still don’t have it.
It’s not a complicated process. You walk into an office, give them some information, and they give you health insurance, easy peasy lemon squeeze.
Seriously! Because Maryland is one of the 32 states that chose to expand Medicaid under the ACA, for many, many people it is really just that simple. The 2016 maximum annual income for Medicaid is $16,243.
Folks whose incomes are above the Medicaid threshold may also qualify for health insurance. They would be referred to a navigator, in the same office, who helps clients explore their options among the Qualified Health Plans under the ACA. These are subsidized plans; under the ACA, consumers enjoy a price break based on income. In Maryland, you can even apply for either Maryland Medicaid or a Qualified Health Plan online. Enrollment for those qualifying for Medicaid is open all year long.
Those wishing to purchase a Qualified Health Plan may do so during the open enrollment period in the Fall each year for plans starting on January 1st the next year, or within 30 days of a qualifying event such as having or adopting a baby, getting married or losing other health coverage.
The point is: If you qualify for health insurance, get it. You never know when you might really need it. Just one uncovered, major health event can ruin your finances for a very long time.
For more information about health insurance plans in Maryland visit: Marylandhealthconnection.gov/how-to-enroll.
Debbie Anne is a public-health nurse with the Frederick County Health Department. She has been awarded a Governor’s Citation for her work with Marylanders living with HIV.
- Headlines2021.10.08Priorities for Maryland’s Commission on LGBT Affairs
- Current Issue2021.04.23The Pride Center of Maryland (PCOM) Launches First Billboard Campaign
- Current Issue2021.01.31Mental Health Moment -Mindfulness and You
- Current Issue2021.01.20In Memory of Milton Lentz, February 18, 1941 – January 20, 2010 – More than a Decade Today and Still Learning to Cope