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Eligible for Individual Insurance with HIV?
Aug 31, 2004

Dear Lynn,

I cannot thank you enough for answering my question posted 8/1 about being eligible for COBRA if I take legal action agaisnt my emplower. Even though I am in NYC, and have went to several organizations, no one could answer my question. This forum is such a service to the HIV community and I hope it is around for a long time -- it is needed. I have one more question: It is very possible I may decided to do freelance work as an artist (my dream career) if I leave my current job. Obviously, I would have to pay for my own insurance. If I join COBRA when I leave my full-time job, and then try to buy individual insurance for myself, will I be able to having HIV? Will I have to disclose I have HIV and if they know, will the cost be prohibitly expensive? Also, do you know of any good companies to go to that offer private insurance with people living with HIV? Thank you so much in advance!!!

Response from Ms. Franzoi

As long as you elect COBRA coverage when you leave your current employer and maintain your COBRA coverage for the full COBRA period, once your COBRA coverage ends, you will be eligible to purchase coverage in the form of a HIPAA policy. An insurer that markets individual policies must sell coverage to an individual who was covered under a group plan (your COBRA coverage in this case) and loses the coverage (due to the expiration of your COBRA period) as long as there isn't a lapse in coverage of greater than 63 days. The new policy which will be a HIPAA policy because you are HIV+ will be more expensive than a standard policy. Your prior coverage under COBRA would count towards any pre-existing exclusion period in this HIPAA policy and since the maximum pre-existing exclusion period allowed is 12 months, your 18 months of COBRA will more than cover that. So no pre-existing exclusion would apply to you. I would suggest checking with Blue Cross or Blue Shield for their PPO or HMO plans. Also check with HMOs in your area. For example, if you were in LA, I would recommend that you check with PacifiCare or Kaiser.

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