Veterans pay
Why are former soldiers shelling out more for AIDS drugs than everybody else?

By Tali Woodward

Patient A is sick with AIDS and makes $35,000 a year. The federal government pays every last cent of his prescription drug costs. Patient B, who has the same disease and the same income, must pay $7 each time he needs a prescription filled – which can add up quickly for a heavily medicated AIDS patient.

What's the difference between Patient A and Patient B? The second one is a military veteran.

It's a strange twist in the complicated web of government programs designed to help disadvantaged people get their meds – one that is unknown even to most people who are affected by it. An estimated 20,000 patients with HIV seek care at the country's Department of Veterans Affairs hospitals each year.

But under the current system, some of the most needy are having to pay for drugs they would get for free if they hadn't served in the armed forces. And the discrepancy may get bigger soon. President George W. Bush's proposed budget for 2006 would more than double the co-pay the V.A. charges for all prescriptions – bumping it from $7 to $15.

The federal AIDS Drugs Assistance Program pays all drug costs for any AIDS patient who makes less than $37,240 annually (the thresholds are a little higher if you have dependents). But you can't enroll in ADAP if you're getting care elsewhere – including through the network of medical centers managed by the V.A. So some vets who go to places like the San Francisco V.A. Medical Center for treatment end up paying for AIDS prescriptions they could otherwise get for free.

Under national V.A. policy, drugs for ailments that are "service-connected" – that is, directly attributable to military service – are provided free. The feds also cover the costs of all medications for vets who make less than $10,162 a year. But any vet who makes more is expected to pay $7 a medication.

San Francisco V.A. Medical Center spokesperson Gene Gibson said, "Obviously people who are over the means test are considered people who can help pay." But Gibson also pointed out that the V.A.'s policies are determined by Congress. "We're just following what the guidelines are."

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