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Major Medical
Dec 6, 2004

Are there usually any sort of exclusions/pre-existing clauses dealing with HIV. Are there any things I should look for/avoid in selecting a policy? I am HIV+, but in good health.

Thanks!

Response from Ms. Franzoi

Most individual health plan policies require you to answer a medical questionnaire. If the insurer agrees to provide coverage based on your responses, the policy will probably have a pre-exisiting condition exclusion for HIV-related illnesses for a period of time. If you are currently covered under a group policy and will be looking for an individual policy once your coverage ends, you can take advantage of HIPAA which would require the new policy to recognize your prior period of coverage towards any pre-existing exclusion period. In selecting a plan, pre-existing condition exclusions, lifetime maximums, the level of prescription drug coverage and, for a PPO or an HMO, the network of doctors and facilites are important features to review.



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