Angelo Trinidad works at GMHC, a service organization that helps people with HIV and stage 3 HIV, also known as AIDS, access care. He shares how people living with HIV can access lifesaving treatment regardless of cost.
Angelo is a Senior Enrollment Coordinator at GMHC in New York City. Healthline spoke with Trinidad about ways to access HIV treatment, regardless of health insurance status, as well as what types of financial assistance are available and how to find out if you qualify.
This interview has been edited for brevity, length, and clarity.
HIV treatment costs include medication, doctor’s visits, and lab work. Biktarvy (bictegravir, emtricitabine, and tenofovir alafenamide) is the medication most often prescribed today for someone living with HIV. Without health insurance, it costs $3,981 a month.
Although costs can vary depending on where you live, most doctors’ visits without insurance cost $350 per visit, and lab work is usually between $150 and $200. How often you get lab work varies depending on where you are in your HIV treatment, but it can range from once a month to every 6 months.
Health insurance can be divided into two types:
- insurance provided by a workplace
- insurance through the state and federal health insurance marketplace
Depending on your health insurance plan, you’ll typically pay a copay for a doctor’s visit. Assuming you go to a doctor who’s in your network, that can be around $20 per visit, although sometimes more.
HIV medications are what’s called tier three, which are brand-name drugs that don’t have a generic version. Depending on your insurance, that will usually be around $40 per monthly prescription. The cost of lab work with health insurance can vary but costs less than without health insurance.
Every state has its own AIDS Drug Assistance Program (ADAP), which provides access to HIV medications for people with limited resources or no health insurance. ADAP has health navigators who can help determine what services you qualify for and help you enroll in them.
Immigration status is not a factor for enrollment, and we can often get people approved for benefits the same day they apply. The income limit for these services varies by state, but you could be working and still qualify. On a national level, ADAP is part of the Ryan White HIV/AIDS Program.
In addition, there’s Medicaid for people and families who are low income, which provides care for 40% of younger adults with HIV.
There may also be regional-specific assistance programs in your area. For example, if you’re HIV-positive and unemployed in New York City, you can apply for HIV/AIDS Service Administration (HASA) benefits to assist with rent payments.
If your income is too high to qualify for government programs, you may want to look into HIV drug manufacturer financial assistance to help with the cost of medication.
For example, the manufacturer of Biktarvy is Gilead. You can visit the financial assistance section on the Biktarvy website. You fill out the application with details like your income to receive a voucher to help pay for that medication. The savings you qualify for are determined on a case-by-case basis.
Again, it’s really on a case-by-case basis, depending on factors like if you do or don’t qualify for Medicaid, your income, if you’re employed, if you have work insurance, or if you qualify for state insurance. It can be confusing to figure out, which is why it’s best to speak with someone who can help you.
You should speak with someone like me!
Reach out to your state’s ADAP, even if you think your income is too high. We can help guide you to the right resources. A health navigator can do a quick questionnaire to ask things like where you live, if you’re working, how much you earn, and whether your employer provides insurance.
Angelo Trinidad is a Senior Enrollment Coordinator at GMHC, a New York City service organization that helps people with HIV and stage 3 HIV, also known as AIDS, access care and treatment. He oversees the AIDS Drug Assistance Program (ADAP), which helps uninsured people with HIV. Inspired by a strong desire to give back to the community, Angelo has worked at GMHC since 1998.
If you have questions about accessing HIV treatment, you can email Angelo at AngeloT@gmhc.org.