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New Job, Health Insurance
Dec 15, 2006

I will be starting work at a law firm in the Fall of 2007 (my first job post-law school). The firm offers group health insurance plans (PPOs and HMOs). I have several questions re: my benefit selection. 1) Do I need to disclose my HIV status under these plans if they are company sponsored? 2) Will my HIV status affect my premiums, or does the fact that this is a group plan shield me? 3) Is there any advantage to a PPO v. HMO, and vice versa, for people with HIV? 4) Will these plans cover blood tests, etc., or will I be stuck paying big bills? Your help is much appreciated.

Response from Ms. Franzoi

Please see my responses below: 1) No. 2) No. You will be a participant in a group-health plan and the cost to you would be the same as any other similarly-situated employee. 3) The PPO will offer more freedom of choice in providers but you will have co-pays and have to file claims for reimbursement. With an HMO, there are no claims to file and a flat fee is paid at the time of the service - office visit, hospitalization, etc. However, you will have to stay in-network and under most HMO's, go through a primary care physician (PCP) for referrals to specialists. 4) Both plans will pay but the PPO will be more costly as you will have a deductible before the plan pays, then a co-pay which might be 10% or 20% (higher if out-of-network) but there will be an annual ou-of-pocket maximum to limit your overall expenditure.

Information comparing the plans should be available in your new hire information package on benefits.



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