The AIDS Beacon™

People living with HIV/AIDS may encounter discrimination in many areas of their life, including obtaining and keeping health insurance and employment. However, HIV-positive individuals are protected by federal law in the employment arena, which includes obtaining employment, job assignments, promotions, wages, and firing policies.

In 1990,the Americans with Disabilities Act (ADA) was passed to insure that individuals with disabilities were not discriminated against. HIV and AIDS are both considered disabilities under this law. However, the ADA only applies to public and private employers who have 15 or more employees.

Individuals are protected by this act only if they are employed in a setting with 15 or more workers and can perform their job duties. If special accommodations for individuals are necessary, they should be made as long as they do not posses a significant burden or financial cost to the employer.

Employers are also prohibited from asking if an individual is HIV-positive during the hiring process. However, they may inquire about a prospective employee’s overall health. If an individual wishes to disclose his or her HIV status to an employer, this information must remain confidential.

While those who are HIV-positive may face discrimination in the workplace, discrimination is most blatant when it pertains to health insurance.

Under the ADA, individuals employed by a company with 15 or more employees are entitled to the same health insurance that is provided to other employees. Individuals who are part of a group insurance under this condition cannot be denied coverage or required to take a test for HIV antibodies.

However, for people with HIV/AIDS who obtain individual policies, the same federal laws do not apply. Individual policies tend to be very costly. With these policies, insurers may ask about an individual’s HIV status. In many states, insurers may also require an individual to be tested for HIV before approving coverage.

The existence of AIDS and other preexisting conditions can result in the denial of or significantly higher rates for coverage. A preexisting condition is usually defined as a medical condition that existed before a patient has obtained health insurance. Conditions that a person has received treatment for, or should have received treatment for, are included in this definition.

Cindy*, a customer service representative from Blue Cross Blue Shield, said they will not deny coverage to an individual based on a preexisting condition.

“We are the insurers of last resort,” she said.

She added that many competing companies do not follow these same policies and will deny coverage based on preexisting conditions.

She also added that many times, people contemplate not disclosing their HIV status to insurance companies.

“This is never a good option because insurers will eventually discover the diagnosis from doctor’s visits receipts submitted for payment and medical records,” she said.

Intentionally hiding this information is also considered fraud and an individual will be dropped from coverage once fraud is discovered.

Insurance companies specifically for individuals with HIV/AIDS do exist. AIDS Health Insurance Program (AHIP) is available to those who are not eligible for Medicaid and cannot afford their own health insurance. However, an individual must be currently insured to participate and also have a monthly income no higher than $1,559 for single households or $2,096 for a household of two. AHIP pays health insurance premiums, excluding co-payments and deductibles.

The AIDS Drug Assistance Program (ADAP) and the Ryan White Program are both federally funded programs that assist low-income individuals with HIV/ AIDS that have a yearly income less than $55,000. The ADAP provides HIV medication approved by the Food and Drug Administration to those with limited or no health insurance. This program runs in all 50 states. According to the ADAP Monitoring Project Annual Report, 3 out of 10 HIV-positive individuals have received assistance from this program.

The Ryan White Program provides funding to low-income cities to help provide services for people with HIV. Specifically, this program pays for emergency room visits, dental visits, laboratory costs, transportation, and housing assistance for uninsured or under-insured individuals with HIV.

For more information on finding assistance programs in your area, visit the Health Resources and Services Administration.

*It is Blue Cross Blue Shield’s policy to not disclose employees’ last names