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Pre-existing condition question
Feb 13, 2008

I have been hiv+ for 4 years now. when I was diagnosed, I was unemployed. I applied for ADAP asap. Months later I found a job and received health insurance so that I could see a private HIV doctor as opposed to a clinic. I did receive pre-existing condition questionaires, I filled them out, and I was approved coverage. (at the time I was not on medication, etc). years later I quit my job, and am currently freelancing. I'm on ADAP again and just a month ago I started meds (atripla). When I am offered a full time job, will the fact that I have already started meds have an effect on whether or not I am approved for health insurance? or does the fact that I am on ADAP and not some other private health insurance company have something to do with this also? I have no idea what the rules regulations and loopholes are here, all i know is that I am currently watching Sicko by Michael Moore and I am TERRIFIED.


Response from Ms. Franzoi

When you start a new job that provides health coverage, if the plan has has a pre-existing exclusion provision in it, it will apply to you because you are in treatment for HIV/AIDS. However, the exclusion cannot be for more than 12 months. Some employer-sponsored plans do not have a pre-existing condition clause. Are you covered under Medicaid? If so, and if you don't have a break in coverage of 63 days or more from Medicaid before your new coverage begins, even if the new plan has a pre-existing condition clause, it would have to recognize your prior coverage under Medicaid towards this exclusion period. This is called "Creditable Coverage." I do not think ADAP qualifies as Creditable Coverage. However, you could inquire as to whether or not it does.

Insurance Coverage of HIV Meds...
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