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health insurance coverage
May 4, 2007

Hi there, I am an American citizen who has lived abroad most of my life. I am looking to move back to the U.S. and have never had health insurance there before. without a current job, and only savings, how hard will it be to get insured having hiv? I am aware that there are some companies offering benefits to "high risk" groups, how expensive are these premiums? also, how long to you have to reside in the U.S. before being eligible for govt. health benefits?

thank you

Response from Ms. Franzoi

Your best option for obtaining coverage would be to become employed in a job that offers benefits, including health care, and to enroll in the employer-sponsored plan.

Most insurance companies only offer coverage to high risk individuals who qualify for a HIPAA policy. A HIPAA policy is available to any individual who has had prior group coverage and has not had a break in coverage of more than 63 days. Any insurance comnpany that offers individual policies must make HIPAA policies available. However, I do not know whether or not coverage under a foreign health plan or program would be consisdered prior coverage.

Some states, like California, offer major risk medical insurance programs (MRMIP). In California, to be eligible, you have to be a resident of the state, not eligible for Medicare, not eligible for COBRA and unable to secure coverage (proof of denial is required). I am not familiar with how the programs work in other states.

In most instances, in order to be eligible for Medicare, you have to be eligible for Social Security benefits as a result of being age 65 or disabled as determined by the Social Security Administration. Eligiblity for Social Security requires 40 quarters of contributions - usually 10 years of employment during which you pay into Social Security and Medicare. There are some instances under which teachers who paid into Medicare but not Social Security are Medicare eligible as long as they have 40 quarters of contributions and meet the other requirements.



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