In order to qualify for the AIDS rate, the enrollee has to have a CD4 count below 200. All pharmaceuticals are carved out of the capitation rate. There is no global adjustment. There is an AIDS rate. The program provides low-cost health insurance to residents who have been denied health insurance or are considered uninsurable.
Eligibility is open to Utah residents who meet the plan s underwriting criteria.
Participants also must apply within 30 days of being denied coverage by a private insurer. Individuals who qualify for Medicaid through the Spend-Down Program, if their spend down amount is more than the plan s premium, may also qualify for coverage. As of July 1999, there are 983 participants in the program. The insurance covers 80 percent of most expenses after the deductible is met. No significant limitations are noted for AIDS care.