The AIDS Law Project’s Access to Healthcare is an exceptionally effective program that makes a real difference in the lives of people with HIV/AIDS. Fully 27 percent of the clients who come to the AIDS Law Project are looking for some form of public or private health insurance as the road to health care because with treatment this disease — once a short-term death sentence — can be treated as another chronic, manageable condition. The key is access to health care and medications. Through this program, uninsured people with HIV/AIDS enroll in Medicaid, Medicare, Social Security disability benefits and private insurance. Accessing health care makes a real difference not just in the lives of clients who continue working and raising their children but also in the impact of the disease on the larger community. People with HIV/AIDS whose conditions are stabilized through health care contribute more than they cost society.
PUBLIC BENEFITS:
Public assistance programs can be a lifeline for people with HIV by providing a monthly income, access to medical care, and help with some special needs. The rules for these programs are complicated. Before applying we recommend that you find a case manager can help you. To find an AIDS service organization in the Philadelphia area, call the Health Information Hotline at 1-800-985-AIDS (2437) if you live. In other parts of Pennsylvania, call the State AIDS Fact Line at 1-800-662-6080. National and state officials often make changes in the public benefits system, and many benefit levels (as in money amounts) change from year to year. For up-to-date benefit levels, ask your case manager.
Updates/Resources/Glossary:
Updates:
List of 2012 Benefit Amounts and Income Limits for Benefits from the Social Security Administration and Department of Public Welfare
Income Comparison of SSI, NMP, MNO, and 2012 Federal Poverty Income Guidelines (FPIGs) 
Prescription coverage limits for some Medicaid recipients 
Bulletin on Hospital Uncompensated Care Programs and Charity Care Plans
Pennsylvania Department of Public Welfare Resources:
Compass, Pennsylvania’s online resource to apply for a broad range of social programs, is available at www.compass.state.pa.us
Official State Website which includes an application for Cash Assistance, Food Stamps (now called SNAP) and Medical Assistance
Cash Assistance Handbook: http://services.dpw.state.pa.us/oimpolicymanuals/manuals/bop/ca/index.htm Medical Assistance Handbook: http://services.dpw.state.pa.us/oimpolicymanuals/manuals/bop/ma/index.htm SNAP/Food Stamps Assistance Handbook: http://services.dpw.state.pa.us/oimpolicymanuals/manuals/bop/fs/index.htm LIHEAP Assistance Handbook: http://services.dpw.state.pa.us/oimpolicymanuals/manuals/bop/le/index.htm
Here are two tools for calculating SNAP (formerly Food Stamps) eligibility and benefit amounts: an automated calculator and a computation sheet.
The Special Pharmaceutical Benefits Program covers prescriptions and some lab services for people who have been prescribed HIV medications. SPBP applications and re-enrollment forms may now be submitted by email to spbp@magellanhealth.com. Click here to download a copy of the application.
The Health Insurance Premium Payment (HIPP) Program is for Medical Assistance recipients with access to health insurance through their jobs. Click here for more information on the HIPP program. Click here for information on co-payments for Medical Assistance recipients who use their Access Card to receive care. Please note that these copays are not enforceable. If a client cannot afford the copay, they should still get the service but can be billed for it afterwards.
Pennsylvania Department of Labor Resources:
Pennsylvania Department of Labor and Industry’s Bureau of Worker’s Compensation
Pennsylvania Department of Labor and Industry’s Unemployment Compensation
Social Security Administration Resources:
Effective August 15, 2011, the Philadelphia Social Security offices will be open to the public Monday through Friday from 9:00 am to 3:30 pm. SSA district offices will no longer issue replacement SSA cards. Federal government site for the Social Security Administration Social Security’s Program Operations Manual System (POMS) This section of the SSA Program Policy Information Site contains the public version of the Program Operations Manual System (POMS). The POMS is a primary source of information used by Social Security employees to process claims for Social Security benefits. The public version of POMS is identical to the version used by Social Security employees except that it does not include internal data entry and sensitive content instructions.
Federal government site for Medicare
PRIVATE BENEFITS:
Private benefits primarily cover three kinds of insurance: health insurance, life insurance and disability insurance. Insurance policies are legal contracts. Just like any contract, it is important that you read your policy and understand its terms. People living with HIV and AIDS who buy insurance have certain rights. For example, your insurance cannot be canceled because you have HIV or AIDS. You cannot be tested for HIV unless you agree to the test. However, in many cases, insurance companies can legally deny you insurance because you have HIV or AIDS. This means that in some cases, if you do not agree to be tested for HIV, the insurance company can deny you for this reason as well.
Resources/Glossary:
Consolidated Omnibus Budget Reconciliation Act (COBRA). A federal law that permits qualifying employees to maintain group health insurance after leaving employment. The qualified employee may be required to pay the full cost for the coverage. COBRA coverage has limited duration, but in most cases the maximum COBRA period is 18 or 36 months. Pennsylvania also has a “Mini-COBRA” law that gives employees of small businesses (2-19 employees) who receive health insurance from their employers the right to purchase continuation health insurance after they leave employment. It allows eligible employees and dependents to purchase health insurance for nine months after their employment ends. An employee or dependent eligible for Mini-COBRA coverage may not be discriminated against on the basis of any evidence of inability to be insured. For more information about Mini-COBRA, call the Pennsylvania Department of Insurance at 1-877-881-6388 or go to http://www.portal.state.pa.us/portal/server.pt/community/health_insurance/9189/mini-cobra/595814.
HIPAA Creditable Coverage. HIPAA requires that most health plans provide coverage for pre-existing medical conditions and protects the portability and continuity of health insurance coverage.
