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Does group health ins pay for HIV meds?
Jun 11, 2012

My HIV drug is currently paid for by ADAP. I will be getting group health insurance soon. I understand that group health ins has pre existing condition exclusions for 6 to 12 months. Will this include not paying for my HIV drug ?

Response from Mr. Chambers

IF the coverage has a Pre-existing Conditions Limitation (some plans like HMOs usually don't); IF HIV is a pre-existing condition as defined in the policy (it will define what is a pre-existing condition and what isn't); IF you did not have coverage that covered your pre-existing condition that ended within 63 days of your new coverage starting, then Yes, the new plan may not cover your HIV medications for the first 6 - 12 months of your coverage.

If that is the case, ADAP will continue to cover your drugs. Once your plan starts covering them you need to advise ADAP of it so they will only have to pay what the plan does not pay.

Good luck with the new group coverage. If you have problems, write back, Jacques

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