Will Travel Insurance Cover HIV?

Recently a Canadian man diagnosed with HIV asked me what would happen to him if he got sick while traveling out of the country: would his government health insurance protect him; would private travel insurance cover him?

The man, I’ll call him Max to protect his privacy, travels a good deal and from his question it appeared he was skeptical about the value of travel insurance, suggesting that insurers could easily relate almost any type of illness to his HIV and invoke pre-existing conditions exclusions thus leave him high and dry when he needed coverage most..

His question and his concern are valid, and emphasize that people who have tested positive for HIV, the virus that causes AIDS, need to be especially careful when assessing travel insurance, but at the same time recognize that they must have it. Government health insurance is no more generous to people with HIV who become ill abroad than it is for anyone else who encounters an unexpected medical emergency.

As for the question: Will Travel Insurance Cover HIV? Many plans won’t. Some will, with reservations. But until you see it in writing, take nothing for granted. Following are the rules of the game.

Though the medical management of HIV has advanced remarkably since it was first detected and diagnosed in the early 1980s, it remains a serious medical condition that requires constant monitoring and adjustment of medications. The good news is that people newly diagnosed with HIV have pretty well the same projected life span as their peers in the mainstream population. The bad is that the medications they need can have toxic side effects and these need to be monitored and treated as well.

There are people such as Max, who have remained stable over the years, whose CD4 blood cell counts are normal and viral loads “undetectable,” but are still HIV positive and will remain so, a fact of life when applying for travel insurance.

There are some plans, such as TIC Travel Insurance Coordinators, and Travel Underwriters Freedom Plan, to name just a couple, which will not insure people with HIV or AIDS: Period. The TU plan does not specifically disqualify HIV positive applicants in its listing of Emergency Medical coverage, but does so in its General Exclusions section—which suggests a person with HIV considering any travel insurance plan read every single paragraph of the plan. Many insurers will totally exclude HIV applicants because conditions such as high blood pressure, diabetes and kidney disease are increasingly being linked in the medical literature to HIV and the medication used to treat it, and that is an added risk they don’t want to assume.

There are other plans, however, among them RBC Travel Insurance, Manulife FTI (not Manulife Global), and ETFS Medi Select, which do not disqualify HIV applicants from coverage but state they will be subject to the same pre-existing conditions stability requirement as any others with chronic conditions. The Medipac policy for Canadian Snowbird Association members clearly states up front that HIV positive applicants must call for an individual assessment to be medically underwritten (covered—or not—on the basis of your medical status).

Can an insurer indiscriminately link or relate any illness or condition to an insured person’s HIV and therefore deny a claim? No. They must be specific and their argument
must make clinical sense and be convincing enough to the independent assessors and ombudsmen services insured people can now appeal to. (See my website article “Health Insurance Claim Denied? Don’t Take it Lying Down.”)

People with chronic conditions, such as high blood pressure or diabetes or cardiac arrhythmia can usually have these conditions covered if they have been “stable” for a given period. But you have to know how the insurer defines stability.

Stability normally means: no new signs or symptoms in the pre-travel stability period (90 days, 180, maybe more, that’s the insurer’s call); no referral for medical consultation or investigation; no deterioration of the condition; no actual medical intervention or treatment required, no change in the type, brand , frequency or dosage of medication for the specified condition during that period.

Given the monitoring, the medication adjustment, the treatment or monitoring of medication side effects that is part of HIV management, that definition of stability may be a hard one for HIV positive applicants to meet. In short, I wouldn’t count on being able to prove stability of your HIV status, but get everything else covered.

My recommendation to HIV positive travelers seeking insurance is to clearly and specifically ask an insurer: Under what conditions would you cover a person diagnosed with HIV? And then get it in writing. But get the insurance.

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