HIV And Private Health Insurance: What You Need To Know

According to the Public Health Agency of Canada, more than 75,000 Canadians had reported positive for HIV up until 2012. While infection rates have decreased annually since 2008, all these people must now take regular medication for the rest of their lives. Prescription medicines for HIV are often expensive, so it’s unsurprising that many people turn to private health insurance to help with the cost. Find out how HIV infection affects your health insurance, and how to make sure you get the best level of cover possible.

Insurers may not offer coverage for HIV treatment

HIV was once a deadly disease, but ongoing medical research has changed the way this condition now affects people’s lives. HIV-related deaths fell 5 percent every year from 1999 to 2008, and life expectancy for young Canadians with the disease is now almost the same as anyone else.

It often takes many years for insurers to adjust their risk criteria, and some insurance plans still exclude coverage for people with HIV. The insurer may decline coverage for any treatment related to the condition, or may simply refuse to offer any health insurance. Always check what conditions apply to your policy. For example, some insurers may ask you to wait one or two years before you can claim.

Your private insurance needs may differ from one province to another

In Canada, each province manages its own public health care system, and this can affect your access to crucial HIV drugs. Public health funds will generally look for ways to contain the cost of drugs, either by limiting what they will pay for or by asking the patient to pay some of the bill.

Check the criteria for full or partial coverage in your province or territory. Local governments issue a drug formulary, which outlines what the public system will and won’t pay for. Bear in mind that if you are moving between provinces, you may have to wait for 6-12 months before you can start to claim. Private health insurance can sometimes help you cover the costs during this period.

Public health care doesn’t generally cover complementary or alternative HIV therapies

Many HIV patients benefit from complementary and alternative therapies, or extra vitamins and supplements. The public healthcare system in your province is unlikely to pay the cost of these treatments, even though they can improve your health. Fortunately, some private plans will cover the cost of non-standard drugs and treatments.

In most cases, you will need to ask a health care provider to prescribe or refer you for these treatments, and a pharmacist will still need to dispense any drugs. You may also need to pay a fee or co-payment, but this can still save you a lot of money.

International health insurance may not help you in some countries

If you are temporarily living and working outside Canada, international health insurance offers you similar cover to your private health plan at home. In some countries, people with HIV cannot get a residency visa. Short-term visitors will not normally need to declare that they have HIV, but if you are visiting for more than a month, you should consider the health implications.

Most countries will only allow people coming into the country to carry three months’ supply of medicines. Before agreeing to visit or work in another country, you should check whether there are any restrictions on visitors with HIV. It’s important to consider how you will keep up a regular supply of medication and any other treatments you need.

Thousands of Canadian people with HIV now live perfectly normal lives, but it’s still important to make sure you can afford access to the healthcare you need. Look after your ongoing health, and talk to your insurance provider carefully about private health plans. Health insurance, and any insurance for that matter — like Preferred Insurance — is needed to live a peaceful life.

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