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In Recognition of World AIDS Day, DISB Reminds Residents of Insurance Protections

Thursday, December 1, 2016

Washington, D.C. – Today, in recognition of World AIDS Day, the District of Columbia Department of Insurance, Securities and Banking reminds residents of their rights to receive HIV screenings at no cost by either visiting their in-network provider or while receiving care in a hospital emergency department. Residents who have received a diagnosis of HIV/AIDS are also encouraged to access the department’s HIV/AIDS Rx Review Guide when selecting a health insurance plan.

Under the Affordable Care Act, HIV testing is considered a preventive service and is available at no cost when administered by an in-network provider. In the District of Columbia, a patient, if insured by a health benefit plan, can receive voluntary HIV screening at no cost when receiving care in a hospital emergency department, regardless of whether the screening is necessary for the treatment of the medical emergency.  Patients will not be subject to any annual or coinsurance deductible or any co-payment other than the co-payment that they would have had to pay for the applicable hospital emergency department visit.

DISB’s HIV/AIDS Rx Review Guide provides an overview of 11 commonly prescribed drugs to treat HIV/AIDS so that patients can have an idea of their out-of-pocket insurance cost. For each insurance company offering plans for sale on DC Health Link, the guide provides a chart that depicts the name of each drug along with the corresponding drug formulary tier. Residents are advised to reference the chart in the Rx Review Guide alongside their potential plans’ Summary of Benefits and Coverage (SBC) to get an idea of their out-of-pocket prescription cost.

"The Bowser Administration is committed to ensuring the District reaches its bold goal of 90/90/90/50 to end the HIV epidemic by 2020. Knowing your rights and having access to potential costs of treatment allows patients to make more informed decisions about their medical care,” said DISB Commissioner Stephen C. Taylor. “As a society, we have made tremendous strides in breaking down barriers to equitable treatment for patients who have received a diagnosis of AIDS or HIV. But we have work to do. And the goal of Department of Insurance, Securities and Banking is to make sure that progress doesn’t fall back."

For more information about the 90/90/90/50 plan, go to the District's Department of Health website at doh.dc.gov. For more information about DISB, visit disb.dc.gov.