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Author Topic: Just qualified for insurance and then got diagnosed. What will CIGNA do?  (Read 1369 times)

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Offline DeepBreath

  • member
  • Posts: 1
Hi Everyone!

I just got the diagnosis. Totally unexpected. The only real prevention is abstinence. It is what it is. A new chapter. My goal right now is to outlive my mom. I'd hate for her to ever have to bury me. Bleak I know but my first tear had her name on it.

This site looks like a very cool resource. Nice to be in such compassionate company.  Since affordable treatment seems integral to everything else, I'd be grateful for some insight.

I am self-employed in California and recently purchased a Cigna PP0 Plan that covers brand-name meds after a $500 annual deductible. I didn't have a single pre-existing condition. My monthly premium is $264.

Six weeks later, I went to see my doctor (Internist/HIV Specialist/Awesome Guy) to get my annual physical and tested positive for the virus.

What now? Can Cigna drop me? Will my premiums go up? Will they consider this a pre-exsiting condition and not cover my meds, treatment or labs? I don't think it's a good idea to call them with these questions yet so I figured I'd turn to you.

Thanks

Deep Breath

Offline intaglio

  • Member
  • Posts: 170
  • Doesn't have to pay for vowels
Re: Just qualified for insurance and then got diagnosed. What will CIGNA do?
« Reply #1 on: September 15, 2013, 05:32:47 AM »

What now? Can Cigna drop me? Will my premiums go up? Will they consider this a pre-exsiting condition and not cover my meds, treatment or labs? I don't think it's a good idea to call them with these questions yet so I figured I'd turn to you.

Most all insurers consider preexisting conditions as things you've sought treatment for in the past. Anything that has appeared in your medical history can be considered preexisting. Your HIV diagnosis is very much in the present -and past the point of your initial start of insurance coverage.

Can they drop you? There is usually a short window of time where they can -but only for reasons relating to your application or non-disclosure of medical conditions. Six weeks have passed, so likely you are in the clear. IANAL, but because this is healthcare coverage, there are limitations to what companies can do to drop people after they've agreed to cover them.

Will your premiums go up? If your coverage is locked in for a specific time period, ie. six months or a year, they cannot change what they charge you during that time period. Once that period is over, they can easily modify their terms or drop you (2014 and Obamacare regs notwithstanding).

Your state government has an Insurance Commission or Insurance Oversight department. Find it. Contact them. They will tell you what Cigna can and cannot do at this point.

Since you are newly diagnosed, seek out an ASO (AIDS Service Organization) in your area. The better ones have insurance gurus on staff that can help you navigate the pitfalls and avoid them. They might also be able to answer your questions.

If the worst happens and you lose your Cigna coverage, the ASO will be able to help you find other coverage and help paying for your HIV meds.
Reality is frequently inaccurate.

Offline moxieinme

  • Member
  • Posts: 90
Re: Just qualified for insurance and then got diagnosed. What will CIGNA do?
« Reply #2 on: September 15, 2013, 08:38:47 AM »
I just got the diagnosis. Totally unexpected. The only real prevention is abstinence. It is what it is. A new chapter. My goal right now is to outlive my mom. I'd hate for her to ever have to bury me. Bleak I know but my first tear had her name on it.
Welcome Deep Breath,

Sorry to hear your coping with a recent HIV diagnosis. It can be hard, but you are fortunate to know your status so you can take preventative action. There are terrific options available to you and barring other non-HIV health conditions you should expect to live and long and healthy life if you take care of yourself.

Re your Mom, after I came out to my folks about my newly-diagnosed HIV status in 1989, my Mom prepared for years to have me move home and take care of me in my dying days. Years later I wound up moving closer to take care of both my parents, then her and even after almost 25 years of HIV, there is little doubt I will outlive her. So I don't think that's anything you have to worry about, again, barring any unusual circumstances aside from HIV.

And I can't add any more re the insurance to what intaglio said. Excellent advice all around.

Good luck!

JD
Salvage therapy wrangler, riding the poz bronco and dodging bullets for over 24 years.
- - - - - - - - - - - - - - - - - - - - -
CD4 at diagnosis 1989 = 330
Began treatment (AZT) 1989
Lowest labs 1998: CD4=74, 7%, VL=750,000
First sustained undetectable VL in 20 years (2009); CD4=315
Current labs (12/13): CD4=637, 27%, VL=<20
Current meds: Prezista, Isentress, Intellence, Norvir

Offline darryaz

  • Member
  • Posts: 450
Re: Just qualified for insurance and then got diagnosed. What will CIGNA do?
« Reply #3 on: September 15, 2013, 10:06:51 AM »
I'll echo Moxie in that at one point my parents switched around their lives to take care of me in my "last days" but now the tables have turned and I'm largely taking care of them in their old age.

HIV drugs work beautifully these days.  Deepbreath, you should expect to live a VERY long time.

 


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