Health Coverage Basics

Health coverage can provide eligible clients with affordable access to both HIV and non-HIV health care services and medications, and provides financial protection against unexpected costs. There are two different types of health coverage: public and private. Both public and private coverage help to make health care affordable. The Ryan White HIV/AIDS Program (RWHAP) supports health coverage by filling in gaps in coverage and affordability, and addressing remaining barriers to care.

  • Public coverage includes health coverage programs that are funded and administered by a state and/or federal government, such as Medicaid, Medicare, TRICARE, and the Children’s Health Insurance Program (CHIP).
  • Private coverage refers to health insurance that is provided through an employer or union, purchased through a state or federal Marketplace, or purchased off-market from a private health insurance company.

The RWHAP is not health coverage. The RWHAP, including its AIDS Drug Assistance Program (ADAP), provides HIV primary medical care, essential support services, and medications, and fills gaps in HIV care, coverage, and affordability. Eligible RWHAP clients will benefit greatly from enrolling in health coverage to address their broader health needs.

Start Exploring ACE TA Center Tools

The ACE TA Center provides tools and resources to help RWHAP managers, staff, and enrollment assisters to engage, educate, enroll, and renew RWHAP clients into health coverage.

Are you new to enrolling people with HIV in health coverage?

Start with these Resources

  • Plain Language Glossary
    The Plain Language Glossary is a quick guide to common health insurance terms in plain language intended for both RWHAP program staff and clients. The glossary is also available in SpanishHaitian Creole, and as an English/Spanish Comparison Table.

  • Health Coverage Eligibility Decision Tree 
    The Health Coverage Eligibility Decision Tree for RWHAP Clients is an easy-to-use tool intended to help RWHAP staff determine if a RWHAP client is eligible for Medicaid, Medicare, private or employer-sponsored insurance, or Marketplace coverage, depending on the client’s current coverage, income, and citizenship status, and other factors. 

  • Health Insurance Literacy Basics
    This resource is a self-paced, interactive course designed to build the health insurance literacy of RWHAP program staff. Participants will learn how to: define health insurance literacy, use key health insurance terms correctly in conversations with clients, help clients understand their health coverage options, and help clients use and keep their health coverage. 

  • Resources for Enrollment Assisters
    This page includes resources for enrollment assisters that are new to supporting people with HIV, and information for HIV programs and staff who are interested in training, certification and/or funding through the federal certified application counselor or Navigator programs.

  • Importance of Health Coverage for Ryan White HIV/AIDS Program Clients: Microlearning Module
    This microlearning module overviews the importance and benefits of health coverage for RWHAP clients. The module overviews the difference between public and private coverage, and the role of the RWHAP and the AIDS Drug Assistance Program (ADAP). The module also provides health insurance enrollment strategies for RWHAP clients and offers strategies to address common enrollment challenges.

  • How to Enroll Clients in Marketplace Coverage: Microlearning Module
    This microlearning module outlines the basic eligibility criteria for health insurance through the Marketplace, open and special enrollment periods, and financial assistance available. The module also suggests other ACE TA Center resources for RWHAP staff to learn more about Marketplace coverage.

  • How to Enroll Clients in Medicaid: Microlearning Module
    This microlearning module outlines the basic eligibility criteria for health coverage through Medicaid, how to enroll in Medicaid, and the relationship between Medicaid and the RWHAP ADAP. The module also suggests other ACE TA Center resources for RWHAP staff and consumers to learn more about Medicaid coverage.

  • How to Enroll Clients in Medicare: Microlearning Module
    This microlearning module outlines the basic eligibility pathways for health coverage through Medicare, the Parts of Medicare, how to enroll in Medicare, and the relationship between Medicaid and the RWHAP ADAP. The module also suggests other ACE TA Center resources for RWAHP staff and consumers to learn more about Medicare coverage.

  • Dual Eligibility and Enrollment of Ryan White HIV/AIDS Program Clients: Microlearning Module
    This microlearning module provides an update on what Medicaid/Medicare dual eligibility is, types of dual eligibility, the basic pathways by which a person becomes dually eligible, how to enroll dually eligible clients, and the role of the RWHAP ADAP. The module also suggests other ACE TA Center resources for RWAHP staff and consumers to learn more about resources to support clients who are dually eligible.

Are you looking for support with a specific aspect of health coverage engagement and enrollment?

Explore the ACE TA Center’s growing collection of fact sheets, job aids, interactive courses, webinars, and more. View all Tools and Resources using the navigation bar to the right. There you can browse all ACE TA Center content by coverage type or topic area.

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Like what you see? Subscribe to the ACE TA Center’s eNews list to stay up-to-date on upcoming training opportunities, the latest enrollment strategies, health care policy updates, tips for Marketplace and Medicare Open Enrollment, year-round enrollment support, and more. 

Still have questions about health coverage access for RWHAP clients?

Contact the ACE TA Center.