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HIV, legal rights, insurance, and discrimination

Aug 25, 1998

Rick could you please discuss what one may need to know after testing positive to hiv regarding employment, medical insurance. . .

For example, i am currently employed through a company and they provide health insurance through a common provider. The drug perscription policy is that the insurance company pays 80% and i pay 20%.

This is a common scenario amongst many working americans. Does much of this change when the care is for hiv as well as the high priced drugs? Must we inform our employer that we are hiv +? Much has been written about the high price for drugs to fight hiv. Should those of us who have jobs like the one i described be considered lucky because these rules should apply to hiv treatment and drugs as well or should we be prepared for "exceptions".


Response from Mr. Sowadsky

Thank you for your question. Anytime we are talking about legal issues (including insurance issues), there is no single or simple answer, since laws can vary significantly from country to country, and from state to state. In addition, many laws have "loopholes" in them, and they may not cover every situation.

In the United States, there are laws that protect against discrimination based upon a persons disability. These laws protect against discrimination in housing, public services, and employment . Two of these laws are the Rehabilitation Act of 1973, and the Americans with Disabilities Act (ADA). These laws make it illegal to discriminate against a person based on their disability. Disabilities can include physical handicaps, cancer, heart disease, HIV/AIDS, diabetes, and others impairments and diseases. Companies and services must provide "reasonable accommodation" to persons with disabilities. Although these laws cover many situations, and prevent many types of discrimination, they do not cover every situation.

When it comes to insurance issues, this is a very confusing area of law. Insurance laws and coverage can vary depending upon your specific type of policy, if you have an individual policy versus a group policy, if your employers insurance is self-funded, if you are in an HMO, etc. Insurance companies can sometimes legally limit (or deny) coverage for people with certain medical conditions. To find out if your insurance will cover your medical care and medications, read your policy very carefully. If you think your insurance policy is discriminatory in it's practices, my suggestion is to talk first with your insurance company directly. If they are not helpful, contact your State's Department of Insurance. The number can often be found in the government section of your phone book, and the office is usually located in the capital city of your state. If they are not helpful, talk to a lawyer.

In most circumstances, you do not have to notify your employer of your HIV status, unless your employer has a "business need to know". For example, if you need your employer to accommodate a disability that you have (adjusting your work hours, special equipment, etc.), you would have to notify your employer of your disability, so that they can take steps to reasonably accommodate your needs. Unless your employer has a "business need to know", you do not normally have to notify them of your HIV status.

For more information, contact:

ADA Information Line (1-800-514-0301 United States only) Your State/Provincial Department of Insurance Your lawyer Your local AIDS Hotline

If you have any further questions, please feel free to call the Centers for Disease Control at 1.800.232.4636 (Nationwide).

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