A health insurance company cannot require you to disclose your HIV status or take an HIV test as part of the application process (see California Insurance Code [CIC] Section 799.09). However, it can ask if you have received medical treatment for AIDS, AIDS-related complex (ARC), or an immune system disorder other than HIV/AIDS. It may also ask you if you are taking or have taken HIV/AIDS medications. Since HIV infection is not a diagnosis of AIDS or ARC, a health insurer cannot deny health coverage solely because an applicant is HIV positive. If an applicant has been treated for AIDS or ARC, a health insurer can deny coverage based on a preexisting medical condition. CIC Section 10291.5(c)(2) requires that all applications for health insurance (excluding guaranteed issue) prominently display the following notice: "California law prohibits an HIV test from being required or used by health insurance companies as a condition of obtaining health insurance coverage."
If your application for health insurance is declined, you may request the specific reasons for the declination in writing. It is important to remember that an insurance company cannot refuse an application for coverage on the basis of an applicant's race, color, religion, national origin, ancestry, or sexual orientation, nor can they charge higher premiums based on these criteria.
If you have been turned down for health insurance because of a preexisting condition (such as treatment for AIDS or ARC), you may want to consider the following options in an effort to obtain health insurance and/or drug therapy assistance:
Medi-Cal
The California Department of Health Services (DHS) oversees the Medi-Cal program. Medi-Cal is California's Medicaid health care program and is supported by federal and state tax dollars. This program pays for a variety of medical services for people with limited income and resources and/or disabled individuals regardless of any preexisting health condition. If you are eligible, you can receive Medi-Cal benefits as long as you continue to meet the eligibility requirements. Medi-Cal is managed through your local county welfare/social services department. Contact your county Department of Public Social Services for current eligibility information or see the "Resources" section under DHS for related Medi-Cal contacts.
Office of AIDS and the AIDS Drug Assistance Program (ADAP)
The DHS also operates the Office of AIDS for California residents. The Office of AIDS creates educational materials and compiles statistical information regarding HIV/AIDS. Their efforts target publicly-funded HIV/AIDS care and treatment programs and critical prevention strategies aimed to interrupt HIV/AIDS transmission. The AIDS Drug Assistance Program (ADAP) falls under the control of the Office of AIDS.
The ADAP was established in 1987 to help provide HIV/AIDS drug therapy access to individuals who are uninsured or underinsured of low-to-moderate income levels. ADAP is a state prescription drug program that is jointly funded by Ryan White CARE legislation and state funds. The goal of the ADAP is to make available drug treatments that can reliably be expected to increase the duration and quality of life for those living with HIV/AIDS. For ADAP eligibility requirements, please refer to the "Resources" section for contact information.
