I was laid off 8 months ago, but I’m continuing my insurance coverage via COBRA. I am HIV+ but healthy and asymptomatic for 22+ years. Except for my medications (which are VERY expensive…probably close to $24,000 per year if I had to pay for them out of my own pocket), I really don’t have many health expenses ( 2 or 3 office visits per year). I was recently offered a sales position with an insurance company which provide benefit packages for businesses (including group and individual plans). If I accept the position, I will be a 1099 Independent Contractor and will have to purchase my own insurance. I have always been covered by a group policy through my previous employers. My concern is whether I will be able to obtain coverage on my own considering my health issue, and if so, what should I expect to pay? Someone advised me that a low premium/high deductible policy combined with a “gap” policy to cover the deductibles and copays and medication would be the best option. I’ve never heard of a gap policy for a regular medical plan. Do they exist? What would you advise? I live in N.C. if that has any impact on your answer. Thanks!

Purchasing an individual health insurance policy in North Carolina may prove to be an impossible challenge for you, give the fact that you are HIV+. The insurance laws in your state allow for medical underwriting for new applicants for individual health insurance. These means that they can deny your application due to a pre-existing medical condition. You will need to remain on your COBRA coverage until it expires. At that time, you will be able to apply for a guaranteed issue individual health plan through your state’s high-risk pool, called Inclusive Health. We advise that you review the plan benefits well in advance of the expiration date of your COBRA so that you may be prepared for a reduction in benefits from your current coverage. These plans often have maximum benefit limits, including annual caps for medications.

Your other option would be to obtain employment with a company that offers group health benefits for which you would be eligible. The “gap” coverage you are referencing applies to Medicare, and is not applicable to your situation.

Answer by moderator — June 22, 2009 @ 11:12 am

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