September 15, 2008

I'm one of the thousands of people whose health care will be affected by the coming switch to mandatory enrollment into Medicaid managed care. I'm so glad I got information about how to handle these changes from ASC.

I came to ASC in 1992 when I was first diagnosed with HIV and new to recovery. My case manager helped me get the services I needed and focus on staying clean. By 1995, my health was good and I felt strong in my recovery. I'd graduated from ASC's Peer Program and moved up from being an ASC Peer to a full-time staff member. But when my health went downhill, I had to leave my job and concentrate on getting my health back on track. All this time, I've stayed connected to ASC. I get case management services at ASC and am active as an ASC Peer one day a week.

For many years, my medical care has been covered under Medicaid's fee-for-service program, instead of managed care. I get routine and specialized HIV care at Montefiore's Comprehensive Health Care Center. My physician there is an HIV Specialist. She's thorough, she listens, and if there's something she doesn't know, she finds it out for me. When she says, "I'll call you with your lab results," she always calls. She also talks about recovery with me, and I feel respected and cared for.

All this time, I've stayed away from managed care because my health care was working for me as is. But recently, at ASC's training on managed care for people with HIV/AIDS, I found out that soon I will have to join a managed care plan. I also learned that if I don't make the choice myself, Medicaid will make it for me, and that might mean losing access to my current doctor. Now that I understand what's happening and how to deal with it, I'm going to follow my doctor to whatever managed care plan she's in.

If I were to give advice about making your HIV care the best it can be, I'd say, "Get all the information you possibly can to find out which plan suits you best. Get educated about the changes coming in 2009 so that you can get the best medical care possible. That's something we all deserve."

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