Ryan White Insurance Premium Continuation Certification

The UW Health HIV Care & Prevention Program is committed to providing care to people living with HIV, regardless of ability to pay. For those who are uninsured or underinsured, the Ryan White Program provides financial assistance with medical and non-medical services. Note: you do not have to be eligible for Ryan White coverage to receive care at the UW Health HIV Care & Prevention Program clinic.

Am I eligible for the Ryan White Program?

You are eligible for Ryan White coverage if you:

• Are HIV positive

• In 2021: $64,400 annually for a 1-person household; $87,100 for a 2-person household, and so on.

• Are a Wisconsin resident

• Do not have health insurance or have insurance and are responsible for out of pocket costs, including medication copays or coinsurance for office visits

How do I get coverage?

• A clinic social worker will enroll you in the Ryan White Program if you are eligible. Ryan White is the payor of last resort, which means we will provide assistance with enrollment in other insurance options if possible.

• If you ever lose or have a lapse in your health insurance, please call (608) 263-0946 immediately for assistance in obtaining other coverage. This is very important so you can continue to see your doctor, and get your medications.

What does Ryan White cover?

The Ryan White Program covers the costs of medical care and support services for both uninsured and insured eligible individuals. If you are uninsured, the Ryan White Program will cover the primary charge for the service and you may be responsible for a small copay. If you are insured, the Ryan White Program will provide assistance with your copays, coinsurance and deductibles for eligible services.

Will I pay anything if I'm enrolled in Ryan White?

• If you are uninsured, you may be responsible for a small copay based on your individual income. See the fee scale (pdf)

• Please call us to update your income if it changes, so your copay amount is correct
  We do not send these bills to collections

Questions?

Please call clinic medical case managers at (608) 263-0946.

Coverage

Medical Services Within HIV Clinic Ordered by HIV Provider:

• HIV clinic visits with HIV medical provider

• Labs: CD4 count and viral load, resistance testing; Other diagnostic labs, tests, procedures or imaging ordered by HIV medical provider (including ultrasounds, CT scans, MRIs, lung function tests, bone mineral density scans).

• Cervical cancer screening: annual cervical pap smear in HIV clinic and referrals to

• Gynecology for follow-up for abnormal cervical paps, including repeat cervical paps, colposcopies, and biopsies (cervical cancer treatment not covered)

• Anal cancer screening (anal cancer treatment not covered):

  • Annual anal pap done in HIV clinic

  • Referrals to colorectal surgery clinic for anoscopy/biopsy needed for follow-up of abnormal pap

  • Referrals to surgeon for consultation on Condyloma

• Screening and treatment for tuberculosis (TB)

• Screening and treatment for Hepatitis B and C

• Screening and treatment for sexually transmitted infections (STIs)

• Routine immunizations administered in HIV Clinic

• Primary care provided in HIV Clinic

• Urgent care provided in HIV Clinic

• Smoking cessation treatment

Other Services Within the HIV Clinic:

• Medical case management provided by HIV clinical social workers

• Clinical pharmacy consultation provided in ID clinic

• Mental health screening and referral for treatment

• Addiction screening and treatment

• Condoms - external (aka, male) and internal (aka, female or insertable) - and lubricant

Medications:

• Antiretrovirals and other HIV related outpatient medications (primarily covered by ADAP program)

• Other outpatient medications, not covered by ADAP:

• Other outpatient medications prescribed by HIV provider, primary care provider, or psychiatric/addiction medicine provider filled at UW Health Pharmacy.

Services Outside of the Clinic:

• Psychiatric treatment provided by a UW Health psychiatrist

• Psychiatric treatment and groups provided by Journey Mental Health Center (JMHC)
  Covered if referral by HIV provider and scheduled by HIV social worker in designated clinic at JMHC

• Medications filled at UW Health Pharmacy

• Colorectal surgery visits for anoscopy and/or biopsy related to the follow-up of an abnormal anal pap result

• General surgery visits related to the follow-up of an abnormal anal pap result, abnormal anoscopy, or condyloma

• Dermatology visits related to the follow-up of HIV-related conditions or condyloma

• Gynecology visits for follow-up of an abnormal cervical pap result, including repeat cervical paps, colposcopies, and biopsies

• Nutrition clinic visits referred by HIV medical provider

• Ophthalmology visits for retinal exams

• Dental care is available at the Beloit Area Community Health Center or ARCW Dental Clinic

Non-Covered Services (referral to the UW Health Financial Assistance Program ):

• In-patient hospital care

• Emergency department care

• Care that is not HIV- or HIV-treatment related

Additional information

The UW Health HIV Care & Prevention Program receives Ryan White HIV/AIDS Program funding. The Ryan White program provides a nationwide, comprehensive system of care, including primary outpatient medical care and essential support services for people living with HIV who are uninsured or underinsured. The Ryan White program reaches 52 percent of all people living with HIV in the United States.

The Ryan White program is guided by the National HIV/AIDS Strategy, which has the following goals:

1. Reduce new infections

2. Increase access to care and improve health outcomes for people living with HIV

3. Reduce HIV-related health disparities and health inequities

4. Achieve a more coordinated national response to the HIV epidemic

The Ryan White program was authorized by Congress in August 1990 and is named after an Indiana teen who lost his life to AIDS. The UW Health HIV Care & Prevention Program has received Ryan White program funding since 1998 to ensure access to HIV care and support services for people living in Wisconsin, regardless of their ability to pay.

The Ryan White program at the UW Health HIV Care & Prevention Program is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number H76HA00204, "Ryan White HIV/AIDS Program Part C HIV Early Intervention Services Program," $623,793 annually 2018-2021. The UW Health HIV Care & Prevention Program is funded 54% by nongovernmental sources. This information and content of this website are those of the UW Health HIV Care & Prevention Program and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

Ryan White made headlines as a courageous AIDS activist in the 1980s for challenging discrimination against HIV/AIDS patients, and he became a voice for patients across the country.

Ryan was born in Indiana in 1971 and suffered from a hereditary medical condition, hemophilia, where his body had a difficult time coagulating, causing severe bleeding even after a minor injury. He was diagnosed with AIDS in 1984 after receiving a blood transfusion.

When trying to return to school after his diagnosis, Ryan faced backlash from the school district, which barred him from attending classes. He gained national attention when Ryan and his family rallied for his right to attend school. He became a poster-child for the HIV/AIDS movement, which he used to stand in solidarity with other HIV-positive men and women by educating the public about the disease.

Ryan White passed away in 1990, but his memory is carried on through the Ryan White Care Act, which was passed by the United States Congress four months after he died. The Ryan White Care Act is the largest federally funded program for people living with HIV/AIDS and continues to this day.

Ryan White was an inspiration and a leader in the fight to end discrimination against people living with HIV/AIDS and to provide hope that someday there will be a cure.

• HIV HIV

phillipsanned2001.blogspot.com

Source: https://patient.uwhealth.org/education/ryan-white-coverage-and-eligibility

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