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Pre-Existing for Health Insurance?
Nov 28, 2007

Hi, Doctor thanks for the help!

Does going to the Doctor for Acne, and an Ear Infection count as a pre-existing condition for HIV. Also went to the hospital for fatigue and insomnia all over 6 months ago. I currently have health insurance and am now applying for new coverage with Blue Cross, I haven't been tested for HIV - just told by Emergency room Doctors to follow up with Primary Physician because they felt I was overly stressed. If I test HIV+ the month after my new policy become effective, can they deny me coverage?

I have delayed getting tested because I wanted a policy with no deductible and prescription coverage. Just in case my HIV fears are correct.

Response from Ms. Franzoi

Pre-existing condition clauses limit benefits for conditions that a participant was treated for (took medication for, sought treatment for, etc.) during a period of time, typically 90 days, prior to coverage commencing. Acne and and an ear infection do not sound like HIV-related symptoms. Therefore, even if you were determined later to be HIV+, there should not be a pre-existing condition limitation applied with respect to HIV-related illnesses unless there are tests or treatment protocols done that would lead the insurer to determine that you were HIV+ and were treated for HIV-related illnesses prior to coverage commencing.



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