New LTD application: HIV+ and healthy
Oct 31, 2007
I am a very healthy woman who has been HIV+ for almost 10 years. CD4 >900 and VL undetectable on meds. I am a Canadian considering overseas employment with a US organization. They tell me their LTD insurance may not provide coverage for pre-existing conditions - that it would depend on an assessment by the insurance provider and an independent medical assessment at the time of the request. I would say it is highly unlikely that I would fall seriously ill as a result of HIV in the next few years. However, I wonder if you can tell me if HIV+ people tend to have problems in cases like this with insurance providers who try to argue that something is HIV related in order to avoid approving the claim on the basis of it being a pre-existing condition. Say I developed heart disease or breast cancer (god forbid). Am I too cynical?
Response from Ms. Franzoi
Typically, HIV+ individuals have difficulty obtaining LTD coverage from insurance companies on an individual basis. However, if the US organization has a group long term disability plan, if you were to elect coverage during your initial eligiblity period, you should be able to get coverage. Although the plan would have a pre-existing condition clause in it, that typically would only be for an AIDS-related illness during the firtst 12 months of coverage. If you were to become disabled after 12 monthsof coverage, all illnesses, AID-related or not, would be covered. Ask the employer for a copy of the summary plan description that explains how pre-exisitng condtions are treated. In response to your other question re denial of benefits, unless the illness could be deemed AIDS-related (like certain cancers), I don't see them denying the benefit.
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