What You Need to Know About Medicare Enrollment if You Have HIV/AIDS

Medicare doesn’t discriminate based on pre-existing conditions.

Eligibility for Medicare enrollment is based on factors such as U.S. citizenship and time paying into Social Security. Pre-existing medical conditions aren’t a factor for ineligibility in Medicare. If you’re a U.S. citizen who is turning 65 years old, you’re probably eligible for Medicare. If you’re a U.S. citizen who is younger than 65 and on disability, you may also be eligible for Medicare.

Medicare covers HIV testing for many beneficiaries.

Medicare covers annual HIV testing for all beneficiaries between the ages of 15 and 65. For beneficiaries younger than 15 or older than 65, testing is covered if you’re at increased risk for HIV/AIDS. Asking to be tested may be enough to qualify you for a covered test.

You’ll need a separate Medicare plan for dental, vision, hearing, and fitness coverage.

Medicare Parts A and B—Original Medicare—doesn’t include coverage for dental, vision, or hearing. Medicare Advantage Plans are offered by private insurance companies and include all the coverage of Original Medicare, often with additional benefits, like dental and much more. Some of these plans may be available with $0 premiums, deductibles, and copays, so you could potentially receive additional benefits at no additional cost.

You‘ll need a separate Medicare plan for prescription drug coverage.

Original Medicare doesn’t include coverage for prescription drugs. To get these benefits, you can enroll in a Medicare Prescription Drug Plan (Part D) or a Medicare Advantage Plan with prescription drug coverage (MAPD).

Antiretroviral therapy prescriptions are covered under Medicare prescription drug plans.

Medicare plans are currently required to cover all approved antiretrovirals (ARVs) as a protected drug class. You may be able to get assistance with prescription costs through Extra Help or the Ryan White AIDS Drug Assistance Program.

Get Helping With Medicare Enrollment

Finding the right plan and completing your Medicare enrollment can be hard. We’re here to make your life easier. Our Medicare Advocates are available to assist you in finding Medicare plans in your area, evaluating the plans based on your needs—physicians, prescriptions, benefits, and costs—and completing your Medicare enrollment, so you have coverage that fits your lifestyle. Give us a call at 1-800-991-4407 / TTY 711 from 8 a.m. to 9 p.m. Eastern, Monday to Friday.

If you’d prefer to take a more do-it-yourself approach, you can quickly and easily find, compare, and enroll in Medicare Advantage Plans using the Medicare Online Enrollment Portal.