Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date.
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Bay Area Reporter (San Francisco) (12.08.05) - Friday, December 09, 2005
Matthew S. Bajko
"Everybody needs to pick a plan by Jan. 1," said Dana Van Gorder, director of local and state affairs for San Francisco AIDS Foundation (SFAF). "The reason why everyone with HIV needs to sign up for ADAP by Jan. 1 is ADAP is going to help people pay their deductibles and co-payments. It is something we were able to get the governor to agree to before last year's budget," Van Gorder said. "In order for those to occur you need to pick a plan and get prescription drugs from ADAP. If you don't pick a plan, ADAP can't help."
Nearly 50 Part D plans are being offered, and patients should make certain an insurer covers all the medications they currently take as well as medications they took in the past, said Van Gorder. Patients should check that their pharmacy is in the plan and in the ADAP network, he said. "This should not be much of an issue in San Francisco but it could be in rural areas."
Dual-eligible patients receiving primary medical care from Medicare and prescription drugs through Medi-Cal need to sign up for a zero-cost plan.
"If the plan is very difficult with its in-house appeals process, that is bad for HIV people," who would then petition to have a drug covered, said Van Gorder.
SFAF and Project Inform will hold a community briefing on Part D to help HIV-positive Medicare clients understand the program and how to prepare for it. The Dec. 12, 6-8 p.m. meeting will be held at San Francisco's Everett Middle School Auditorium, 450 Church St. (between 16th and 17th streets). A plan finder is available at www.medicare.gov. Also visit www.sfaf.org/policy/medicare or www.projectinform.org/org/medicare/partd.html
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