$3,491

$3,000

 
 

$4,900

January

January

 
 

February

January

$3,491

In the month of January, Tom pays for his HIV medication in addition to his doctor visits and monthly premium. He pays a total of $3,491 to manage his condition.

January

$3,000

Tom hits his $3,000 combined deductible in just one month.

February

$4,900

Tom meets his $4,900 maximum out of pocket in February after spending $1,748 on prescription drugs

January

$3,491

In the month of January, Tom pays for his HIV medication in addition to his doctor visits and monthly premium. He pays a total of $3,491 to manage his condition.

January

$3,000

Tom hits his $3,000 combined deductible in just one month.

February

$4,900

Tom meets his $4,900 maximum out of pocket in February after spending $1,748 on prescription drugs

Patient Profile: Out-of-Pocket Cost Burden

Human Immunodeficiency Virus (HIV)

Tom is a 45-year-old man living in Washington State. He manages a small dog-walking business, through which he makes $3,667 per month. Tom has also been diagnosed with HIV. According to research on family budgets, he is likely to use a bit more than half of his income on necessities such as food, housing, taxes and transportation. The following patient story represents 2014 plan data.

Scroll through the content below to engage with different stages of Tom's health care story or download the PDF here.

Name: Tom

Age: 45

Location: Washington State

Job: Dog Walker

Income: $3,667 per month (500% of the FPL)

Tom does NOT qualify for premium or cost-sharing subsidies

Condition: Human Immunodeficiency Virus (HIV)

Health Coverage: Silver plan

Medications:
Brand-Name Nucleoside Analog Reverse Transcriptase Inhibitor and Several Generics

Additional Symptoms:
Generalized Anxiety Disorder And Hypertension

Monthly Premium: $339

Deductible: $3,000 Combined Medical & Drug

Out of pocket costs (in first month alone): $3,491

Total Costs of Health Care During the Year: $8,968

Total Costs on Premiums and Health Expenses During the Year: $8,968

Plans with High Combined Deductibles and High Coinsurance on Specialty Tier Will Leave HIV Patients with Large Upfront Out-of-Pocket Costs

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