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Question For Nancy
Oct 7, 2001

Hi Nancy, I have three questions. First of all when an employer has a group benifits program that includes a health care plan can the health care plan ask for an hiv test? If so what if you refuse to take the test? Second question if I want to take out a private health care plan can I do that without being required to take an HIV test? Are there companies that will take a person at a much higher rate without the requirement of HIV test? What about HMO's? PPO's? Third question since my job (CPA) does not at least as far as I am aware have anything to do with if one does or does not have hiv can I assume that they are not legally allowed to ask if a person is or is not HIV+ ? I am asking because I have been told that as long as you have no offical HIV diagnosis on your medical records and you do not have any "suspicious" medical events such as persciptions for HIV meds or treatment for things like PCP which is a common Oppertunistic infection for people with aids(usually not found in people with HIV usually occurs more in people with low Tcell counts who have been diagnosised with aids) that most of the time there is a company that will insure you but at a high rate and restrictions such as a 2 year waiting period for certain types of medical conditions such as HIV/AIDS? Do you know if this is true? Do you know any company that you know of that might offer such a policy? For the record I have never been formally diagnoised with HIV/AIDS or seen a physican for treatment of anything to do with HIV. So I am cetain that a reveiw of my medical records would not yield anything that would indicate possible infection. I really could use your help here Nancy so please try and help me out here if you can. Thank you!

Response from Ms. Breuer

You don't mention the state you live in, but I can give you some general help. Some of your specific questions are really Lynn Franzoi territory; no one knows this stuff better than she does, and of course she's available to you at this website. I'll note the items you might want to direct to her.

First, on a group health insurance policy, you are not going to be subjected to an HIV test or any other kind of medical test, as far as I know. (It would have to have changed very recently to be any different.)Group coverage means that the insurance company takes on the whole group, warts and all, and charges premiums based on activity within that group.

Private health insurance is a different matter: there will be an HIV test, no matter what state you live in. As to HMO's or PPO's, I don't have specific information about how they take on new individual members; that's one for Lynn. Yes, there are some insurance companies now that knowingly write policies for HIV+ clients. I don't know names, but Lynn will.

Your question about whether "they" can legally ask about HIV when one works as a CPA is a little confusing; I'm not sure who "they" are. Insurer? Employer? Direct questions about a diagnosis are not legal in a job interview, but many recruiters ask them anyway. Here's how to cope with that: if the question targets a diagnosis, or targets your own private medical information, smile indulgently and say, "I do not have any condition that would prevent me from fulfilling all of the essential functions of my job." That says two things: you're able to haul yourself out of bed each day and do what CPA's do, and you're aware of your rights under the Americans with Disabilities Act. Your employer does not have access to your medical records, and you have no reason to give your employer that access. Answer all questions in terms of your ability to do the job.If you receive a health questionnaire from a prospective employer, indicate that you want to be sure it's correct, so you'll take it to your health care provider to fill out. Then get online fast to Lynn Franzoi or Lynne Gabriel or me and let us know if there are questions that feel too prying. Your doc is accustomed to answering these things with complete medical information, and may not be as tuned in to your confidentiality as we'd all like. There are ways to answer questions in terms of functional limitation, not diagnosis, that are far more useful to the employer anyway. Example: what good does it do you, if you're the employer of someone with lupus, to know that? Do you have a medical degree? Probably not. But if you know from the person's health care provider that they need a half hour break during the work day to accommodate the fatigue of lupus, but can complete the full day by adding on the half hour at the end, now they have something they can respond to. See? It's not what you have; it's what you can or cannot do that your employer needs to have done.

Finally, if the questioner is a health insurance company, there's a hard and fast rule: don't lie. If at any point it is discovered that you have lied, your coverage will immediately become invalid and they can legally ask you to refund money they have paid out on your behalf. Not a pretty picture.

I hope this helps; write back (probably to Lynn) if you need more insurance specifics. I wish you well!

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