Health Insurance Struggles For The Hiv-Positive

2ynqw6f.jpgContracting HIV can be a devastating event. While treatments have improved considerably over the past several decades, HIV-positive individuals still have shorter lifespans than those without the virus. The Human Immunodeficiency Virus attacks a person’s immune system, making them more susceptible to to other diseases. In fact, related conditions are responsible for more deaths than AIDS, the disease it can develop into.

Since they are susceptible to many health conditions, such as pneumonia, that would leave a healthy person unscathed (even a common cold can be serious), people with HIV/AIDS will require more healthcare spending. The expensive prescription cocktails required to slow the virus’ transformation into AIDS is usually not available in generic forms. Finding health insurance can be a Herculean task, especially in the current American system. Most health insurance companies will reject such a patient, because they will lose money from their policy.

In ideal circumstances, everybody would fully protect themselves from HIV: avoiding unprotected sex and intravenous drug use are two risk factors. However, some people have either made bad choices or been deceived. Unfortunately, they have relatively few options. Guaranteed issue health insurance plans come with very expensive premiums, and may exclude at least part of their HIV-related treatments. Their treatment is also likely to exceed annual and lifetime policy limits.

The best case scenario for an HIV-positive person is if they already have existing health insurance prior to their diagnosis. However, that is not always sufficient protection. Some health insurers practice rescission in order to avoid paying for serious, life threatening diseases contracted by a policyholder. Rescission entails automatically targeting those policyholders diagnosed with costly conditions (such as HIV) for fraud, and using the smallest excuse to drop their policy. In one case, an HIV-positive male had his policy rescinded due to an incorrect date written on a note from a nurse that implied that he may have been diagnosed prior to buying his health insurance policy, without double-checking the medical records. Instead, they immediately stopped the investigation and dropped him.

Due to the cost of HIV treatment, a person could’ve died because someone forgot to check a calendar. In the cases of those with HIV, the virus can lie dormant for years after an infection. Even with the best test, it can take up to 30 days for a new infection to show up. If a person buys (and is underwritten for) a health insurance plan after being unknowingly infected with HIV–but before they knew they had it–should that be considered fraud? According to some health insurers, the answer is yes.

These people did the right thing when it comes to insurance: they bought and retained coverage before they were sick with a pre-existing condition. There is often a lack of written policies detailing when insurers can rescind a policy, nor much opportunity for appeals. While singling out HIV-positive patients for discriminatory health insurance rescission is thankfully rare, everyone should be on the lookout for such actions.

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