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HIV and Enteropathy
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Puerto Rico
Health care in states will be profoundly affected by the implementation of the health reform law, starting in 2014, however territories like Puerto Rico will be affected differently.
 
The two biggest changes that will affect HIV patients and HIV care providers in every state are the Medicaid Expansion Option, and the new Insurance Exchange (Marketplace).
 
Medicaid
 
As a provider, it will become increasingly important for you to have access to Medicaid patients in the coming years. All states now have the option of expanding the state Medicaid program to cover all low-income individuals without category. Many states have also made the move to managed care systems in recent years, or may do so in the future.
 
Learn about the decisions the state has made regarding the Medicaid Expansion option, and how to connect your practice to the state Medicaid program system.
 
 
Insurance Exchange (Marketplace)
 
Starting in 2014, the state will have a new Insurance Exchange (Marketplace) run by either the state, or the Federal government. Thousands of uninsured patients in the state will be able to purchase new individual and small group insurance plans offered by insurers.
 
Providers must contract with each insurer separately to be included in the plan’s network.
 
Learn about the state’s marketplace, what insurers are offering plans in it, and how to contact them about including your practice in their network.
 
 
Provider Resources
 
For additional resources and helpful information for providers on integrating your practice with the new systems of care, including contacting insurers, inquiring about contracting, and taking advantage of the health reform provisions designed to help HIV providers, please visit our Provider Resources Section.
 
 
For resources on providing direction to your patients in participating in the new systems of care, selecting the plan that is right for them, and retaining access to their HIV provider, please visit our Provider Resources Section.
 
 
Additional Information
 
Learn more about the Affordable Care Act (ACA) law, including the Medicaid Expansion Option in our health reform policy section.
 
Learn about the State Insurance Exchanges (Marketplaces), and the Essential Health Benefits, that must be covered by the new Qualified Health Plans, and the requirement that they contract with certain Essential Community Providers, like Ryan White clinics.
 
 
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