Medicare HIV fact sheet: caution re January 2006.A two-page fact sheet on Medicare and HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States. is available from the Kaiser Family Foundation The Henry J. Kaiser Family Foundation (KFF), or just Kaiser Family Foundation, is a U.S.-based non-profit, private operating foundation headquartered in Menlo Park, California. , http://www.kff.org/hivaids/7171-02.cfm
Persons on Medicare (not to be confused with Medicaid) will need to make important decisions for the new prescription-drug coverage (Medicare Part D) that begins in January 2006. This fact sheet can help them get ready.
How many HIV patients will be affected? According to according to
1. As stated or indicated by; on the authority of: according to historians.
2. In keeping with: according to instructions.
3. the best information available, cited by the fact sheet, 19% of persons in HIV care were on Medicare as of 1996. The proportion may be larger now; a separate study of Medicare billing records found that the number of people on Medicare and receiving HIV treatment increased 50% between 1997 and 2001 (the references are on the fact sheet). Most importantly Adv. 1. most importantly - above and beyond all other consideration; "above all, you must be independent"
above all, most especially , about two-thirds of the 19 percent on Medicare were also on Medicaid: this is important because for those patients on both programs ("dual eligibles"), Medicaid drug coverage will end and patients will need to get their medications through a Medicare drug plan instead. There is a risk that treatment for these patients may be interrupted in early 2006 because new arrangements are not ready in time.
The fact sheet lists son]e of the issues that will affect peoples' choices of a Part D drug plan for persons with HIV who have Medicare: "Formularies (the list of drugs offered) will vary by plan. Medicare drug plans must cover all antireiroviral medications but not necessarily all other medications needed by' people with HIV/AIDS HIV/AIDS Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome . Other aspects of the new law that may affect people with HIV/AIDS include: how quickly newly approved drugs will be added to formularies; whether plans will cover off-label uses Off-label use
A drug that is prescribed for uses, periods of time, or at dosages that are not FDA-approved.
Mentioned in: Antidepressant Drugs, SSRI
off-label use for drugs (sometimes important for people with HIV/AIDS); whether dual eligibles will face temporary lapses in drug coverage as their drug benefit shifts from Medicaid to Medicare: the gap ("doughnut hole") in prescription drug prescription drug Prescription medication Pharmacology An FDA-approved drug which must, by federal law or regulation, be dispensed only pursuant to a prescription–eg, finished dose form and active ingredients subject to the provisos of the Federal Food, Drug, coverage for many beneficiaries until their true-out-of-pocket (TrOOP) costs reach catastrophic coverage thresholds; and the uncertain impact of the Medicare drug benefit on ADAPs ... since ADAP ADAP AIDS Drug Assistance Program
ADAP Alcohol and Drug Awareness Program
ADAP Agricultural Development in the American Pacific
ADAP Airport Development Aid Program
ADAP Advanced Digital Antenna Production spending for those in the doughnut hole will not count toward TROOP."
The 19% or so of people with HIV who have or are eligible for Medicare will need to choose a plan by January 2006. While the new Part D drug benefit is voluntary (except for those also on Medicaid, whose Medicaid drug coverage will be replaced with Medicare), it will usually be strongly in peoples' interest to join, especially if they have or are likely' to have large prescription-drug expenses. For many people, making a good decision in this necessary but ill-designed and complex program will be difficult.