Small Companies, Insurance and HIV Care
Feb 23, 2005
I have been positive for the past two years - currently, I am not on any meds since my numbers are still ok. I see the doctor every 3 months for routine check up.
I work for a small company of about 16 members. I must say, the company has been struggling to give us adequate coverage, and every year, it is a negotiation to get coverage. I do have a feeling that any worker with a condition that could potentially increase the company's coverage could be viewed as an burden.
As a result, my routine visits to the doctor are not covered by my company's insurance agency - i handle it privately.
It is getting to a point where i feel I should disclose my insurance coverage to my HIV care specialists. But i have a lot of questions:
1. would my company be aware of my condition in any way - lets say when they are about to renew their policies and note sudden increases?
2. second, once my diagnosis is on record with my insurance company, will it affect my eligibility for other insurance (life, medical, etc)?
3. Can subsequent employers find out about my condition through review of my medical records directly or indirectly?
thanks - JJ
Response from Ms. Breuer
JJ-- Good questions. Here's what I know:
Your employer's health insurance plan should have a confidentiality shield in it, so that the employer is not receiving diagnostic information at all, only usage reports. However, because your company is so small, claims review may be done by a company employee. Check with your HR staff person--or call the insurance company that provides service to your employer--to learn how medical confidentiality is protected in your environment. What barriers are in place to keep diagnosis information from the employer?
If your treatment for HIV becomes part of your medical record with your employer's insurer, your eligibility for other group insurance is not affected. Any company where you apply for individual coverage is going to test you for HIV anyway, so paying for treatment yourself or submitting claims against your health insurance provider will make no difference in your ability to acquire other forms of insurance later on.
YOur employer does not have access to your medical records. Strict new provisions of the HIPAA act mean that there are severe penalties for unauthorized disclosure of medical information. Those regulations apply to your medical providers and to your employer. No employer with good sense is going to even try to learn someone's diagnosis--once they have it, they're liable for misusing it. The most common way for employers to learn an employee's HIV status is from the employee confiding in a co-worker who then blabs. Co-workers are not held to the disclosure requirements of HIPAA; employers and people who represent the company (such as officers and supervisors) are.
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