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Need Adivce on Insurance.
Aug 28, 2003

Resently I have been to the doctor alot with GI and headaches. I thought it was HIV, but all test are negative. I took another private home test that work on different strains and it was positive. I'm currently working for a company and have good benifits. I'm thinking about applying for an individual plan through blue cross blue shield. If they except me and say within six to twelve months I do find out I'm positive through more advance testing would they have to cover me. I dont think it would be considered a pre-existing condition. Nobody seems to be able to diagnose me.

1.) If excepted under the individual policy and find out later Im positive through advance test can they cancel the policy? 2.) If I pay out of pocket the the individual test and Im positive could the doctor Im seeing through that plan prescribe HIV meds to me without disclosing my private test results? 3.) Have you seen anybody that had a positive test and being treated for HIV under and individual policy have their rates skyrocket eventually. 4.) Im finding in Florida and pretty much any other state that getting individual insurance with HIV is impossible even with being HIPAA eligible. Why doesnt the Government and States see HIV as a treatable disease now and pass laws helping people that dont qualify as low income and self employed to get insurance? People want to work and Im finding out why people are dying of this disease, because our healthcare system in the use sticks and the Pharmaceutical companies control everything. 5.) I dont understand why HIV is the biggest thing on insurance forms. If you look at them HIV will be in bold print and cancer will be in small print. Why is everyone with HIV being descriminated against in this free country? (HA HA) 6.) Im just worried Im going to be stuck without insurance in the end and have to wait for open enrollment next year at our company if its still around. The other thing is the economy stinks and if I lose my job I dont think Ill find another for along time in my industry. 7.) One last thing. If I loose my job and pay for COBRA can I move to a state that is more forgiving for people with HIV and the HIPAA law still apply. Does COBRA carry over to another state?

Your help is greatly appreciated. As you can see Im worried and I dont think Im the only one that is thinking of some of these same questions. I between a rock and a hard place. Please any advice would be greatly appreciated. Thanks

Response from Ms. Franzoi

I previously answered this question but am not sure it was posted due to difficulty with the website.

If you are covered under a group health plan with your employer, you might not be eligible for a policy with Blue Cross or Blue Shield. They typically have language in their applications that requires you to agree to discontinue other coverage if accepted for their policy.

1. If you state on your application that you are not HIV positive and there is evidence in your medical records that you are (i.e., you did not answer the question truthfully), they could cancel your policy. 2. I would think your doctor would want to verify that you are positive before prescribing any meds so it would be in your records. 3. Individual policies are ususally community-rated and the premium is based on age and zip code not individual experience. However, there could be a lifetime maximum on benefits payable. 4. This is more of political question and not a Q&A for this forum. 5. See response to number 4. 6. If you lose your job, you would be eligible for COBRA (assuming the company still exists) and at the end of COBRA you would be eligible for a HIPAA policy as long as you don't go more than 63 days without coverage. 7. It depends on the plan. If your COBRA coverage is under an HMO or PPO that is only available in the location you are in now and the company doesn't offer a planb in the area you are moving to, COBRA would not offer you coverage in the new location. If your plan is a traditional fee-for-service plan or your employer offers an HMO or PPO in the area you move to, COBRA would be portable.



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