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Real members of myHIVteam have posted questions and answers that support our community guidelines, and should not be taken as medical advice. Looking for the latest medically reviewed content by doctors and experts? Visit our resource section.
A myHIVteam Member asked a question 💭
Bedminster, NJ

I take Triumeq and my prescription is covered through my employer’s prescription plan.

August 8, 2023
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Answer Summary

Members reassured someone approaching Medicare age that HIV medications are generally covered, though the specifics depend heavily on which... Read more

Members reassured someone approaching Medicare age that HIV medications are generally covered, though the specifics depend heavily on which Part D prescription plan or Medicare Advantage plan you choose, with many sharing that their HIV meds come with little to no out-of-pocket cost. Several members highlighted valuable resources that can eliminate or reduce copays, including the Ryan White ADAP program (which covers copays in most states), state-specific Extra Help programs through Social Security, and nonprofit assistance programs that pay for HIV medications year-round. A recurring theme was the importance of researching your options carefully, consulting with your doctor or case manager about available assistance, and understanding that mail-order pharmacies and specific plan providers like UnitedHealthcare or Aetna can offer better coverage and convenience than traditional retail pharmacies.

A myHIVteam Member

When I turned 65 I was automatically put on Medicare. I already was on Original Medicaid which paid 100% of everything. In CA Medicaid is called Med- Cal. So, when I turned 65 I got hundreds of phone calls and mail to join a Medicaire Advantage plan. Which I never did due to the rural county I live in and the fact I have to travel to a different county in order to access an Infectious Disease doctor as there is not even one in my county.
So...when I was switched to Medicaire being my primary and MedCal my secondary, they also threw in a prescription plan coverage called Wellcare. Started getting co-pays on prescriptions first time since started meds in 1997.
So..cannot tell you what happens if you decide to go on an Advantage Plan because I never did. I am hearing from my friends now that did pick a plan in order to get the freebies that it wasn't worth it and now they wish they never did.
In any case, you'll get some type of prescription coverage.

March 20, 2024
A myHIVteam Member

They get put in a plan covers both in an advantage plan the best of both and you can still see all your doctors free prescriptions free your not losing anything you'll just have both in one plan and no copays and you get your 170.00 back in your social security check each month it's well worth i know

March 20, 2024 (edited)
A myHIVteam Member

You need part D Medicare for your prescriptions. Find out what your co pat will be. In Oregon we have Ryan White funds that buys our Medicare D policy for us

December 5, 2023
A myHIVteam Member

Medicare doesn't cover your partD plan that you pick covers 80% most states EOHHS drug assistance programs with Ryan White covers the rest check it out

December 5, 2023
A myHIVteam Member

I once upon a time used whale mart for my meds then suddenly the scripts disappeared from their system which left me in a real bind .
I got my id pcp to issue new scripts which I promptly took to Walgreens and only had an occasional problem but was resolved with a fone call or three .
Then a while I used the farma y at Publix then it was suggested by the nurse practitioner for diabetes that I get all my meds from one source and that's when my id PCP and social worker convinced me to go with Currant farmacy well as stated in an earlier I have been doing the mail order st hick over 10 years now ( mail order is actually a misnomer because the meds arrive by way of Ups within 3 days of ordering them ) .

August 22, 2023

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