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Individual Health Insurance in California
Feb 13, 2008

My ex-domestic partner is taking me off of his group health isurance effective immediately. I am not eligible for COBRA both because he did not lose his job and they do not offer domestic partner COBRA benefits. I am now applying for an individual health insurance policy. The application clearly states that California law prohibits an HIV test to be used as a condition of obtaining health insurance. Does this mean I do not have to tell them that I am positive? I did answer truthfully to all of the questions, such as "Has applicant taken any prescribed medications in the last 12 months?", but they don't ask which ones I take. Now there is a question that asks if I have a list of endocrine/metabolic problems including AIDS/ARC, immune disorders not including the result for an HIV test. I don't want to give too much information and be refused out of hand, but I also don't want them to cancel coverage at a later date and bill me for everything that they had paid out. Thank you so much for you help! This site is a wonderful resource!

Response from Ms. Franzoi

You must answer the questions honestly. If you fail to do so, not only could coverage be cancelled at a later date but it could be cancelled retroactively and require repayment of claims paid. Since you have been diagnosed as HIV+ and there are most likely medical records that show this, it would be best to answer the question re immune disorders with a yes. Since you have been covered under a group plan, even if the insurer won't cover you under a standard policy, the insurer would have to allow you to purchase a HIPAA policy as long as you don't have a break in coverage of 63 days or more.

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