Colorado Department of Public Health and Environment

STI/HIV Section

The Colorado HIV Care and Treatment Program

 

Health Insurance Assistance Program

 

What is the Health Insurance Assistance Program (HIAP)?

 

Many of those living with HIV disease are able to continue employment at a business which offers healthcare and medication coverage while they manage their treatment. Others are able to maintain a COBRA policy through a former employer while they are transitioning to a new job or to disability. The HIAP is intended to assist eligible participants to maintain access to these benefits. The insurance coverage must provide “creditable” pharmaceutical coverage, and be cost-neutral to the AIDS Drug Assistance Program (ADAP) to provide the same coverage. This program has the additional benefit of providing access to medical treatment for its participants.

 

How do you qualify for the Insurance Program?

  • You must be a Colorado resident
  • You must have proof of HIV positive diagnosis from a doctor or testing facility. You may also access the program if a family member that is not HIV positive can acquire insurance from their employer on your behalf.
  • You or your family must be at or below 400 percent of the Federal Poverty Level, (see below).
  • You must be eligible for medical insurance or a COBRA policy through which you would be able to access medications in an affordable manner.
  • If you are eligible for Medicaid, you must access your medications through that system. The ADAP system must be the payer of last resort.
  • If you are eligible for Medicare, you must receive assistance through the Medicare Part D assistance program (Bridging the Gap, Colorado, State Pharmaceutical Assistance Program). See the Medicare Part D tab to the left.

 

Federal Poverty Level: Based on 2011 figures
400 percent of Federal Poverty:

Persons in
Family or Household

200%

400%

1

$21,888

$43,669

2

$36,392

$58,986

3

$46,509

$74,304

4

$56,098

$89,623

*For each additional family member, add

$7,640

$15,280

 

 

There are two “levels” of assistance under the Insurance Program.

 

Level I
For those eligible at 200 % of the Federal Poverty Level (FPL) or below. Participants can receive up to $10,000 for insurance premiums, as well as medical and pharmaceutical co-pays and deductibles annually. There may be a waitlist for participation in this program.

 

Level II
For those eligible at 400% of FPL or below. Participants may receive up to $8,400 annually in either insurance premiums, or pharmaceutical co-pays each month. The participant is allowed to choose which option he or she finds most beneficial only once annually, unless the participant’s carrier or policy terms change.

 

How Do I Find Out More About the Program?

You do not have to be case managed to participate in the program, but enrollment in the program is managed by the contracted agency in your region. If you think that you qualify for the Health Insurance Assistance Program, inquire at one of the five agencies listed below. You may also call the Health Insurance Assistance Program Administrator at the Colorado Department of Public Health and Environment at (303) 692-2783. You will be asked to complete the AIDS Drug Assistance Program application located at: http://www.cdphe.state.co.us/dc/HIVandSTD/ryanwhite/ADAP Application Final v07272010.pdf