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Group Health Insurance
May 9, 2006

Hi there Ms. Franzoi. Soon I will be offered Health Insurance trough my job as a secondary school teacher. I am currently receiving my medications through ADAP. For this reason, will I be imposed the Pre-Condition clause or will they consider ADAP as past insurance for my disease. Finally, my partner is also HIV positive, would it be possible to enroll him in the insurance as well? Ms. Franzoi thank you for your help and time.

Response from Ms. Franzoi

When you obtain coverage as a teacher, the plan will recognize coverage under group health plans, Medicare, Medicaid, public health plans and other health insurance policies (called "Creditable Coverage") towards any pre-existing exclusion period as long as you don't have a break in coverage greater than 63 days. Not all plans have pre-existing exclusion clauses. Even if a plan does, the exclusion period cannot be greater than 12 months and must be reduced by Creditable Coverage. I do not know enough about ADAP to know if that would qualify as Creditable Coverage because it is only for meds, right? Do you have any other medical coverage? With respect to covering your partner, you will be able to do this only if the plan allows for domestic partner coverage. Some plans do and others do not.



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