Heads Up for PACT Patients

For HIV patients who receive care at Pittsburgh AIDS Center for Treatment (PACT), UPMC, it might be worth noting that impending changes in your healthcare may effect where and how you get treatment. Talking to your HIV clinic social worker might be the best way to prepare. With that said, here are some tips to keep in mind…

If you have health insurance:

  • If Medicare is your primary coverage and you have a Highmark policy, whether a Medicare HMO or Medicare Supplement, you still have access to all UPMC facilities after 1/1/2015. This also includes patients who have medical assistance coverage in addition to Medicare.
  • Currently, the only Highmark plans UPMC does not accept are Community Blue plans.
  • If UPMC refuses Highmark commercial plans beginning 1/1/2015, then patients need to keep this in mind during their employer’s open enrollment period.  Patients who do not have an insurance plan that is accepted by PACT can be referred to AGH Positive Health Clinic.
  • If medical assistance is your primary coverage, UPMC PACT accepts UPMC for You and Gateway Health Plan.   UPMC does not accept the following medical assistance plans:  Coventry Cares, or United Health Care Community Plan for Families.

If you are uninsured:

  • PACT is currently awaiting word from the SPBP program regarding when and how they will begin assisting clients with health insurance premium and/or co-pay assistance. Pennsylvania’s SPBP program is one of only nine states that doesn’t already have a program like this in place.
  • PACT is also awaiting word regarding Governor Corbett’s Healthy PA plan for uninsured individuals with income under $16,105. The Corbet plan is not yet in place so details are unknown for the moment.
  • Open enrollment for health insurance in 2015 through the ACA Marketplace begins November 15, 2014. PACT social workers are available to help and/or answer questions.
  • The Ryan White Program has informed grantees that grant funds cannot be used to pay tax penalties for those who have not signed up for coverage. PACT continues to see patients if they are uninsured.

If you are a PACT patient, and have questions, you can email Pat McGlone at mcglonep@upmc.edu. While this information is specific to patients at PACT, all people living with HIV should be speaking with a social worker or case manager about impending health insurance changes.

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