HIV+ may get medical insurance soon

[Guest guest]

HIV+ may get medical insurance soon

Kounteya Sinha, TNN, Feb 2, 2011, 12.09am IST

NEW DELHI: India could soon see a national medical insurance policy for people

living with HIV (PLHIV).

In a meeting with insurance companies and the Insurance Regulatory Development

Agency on February 3, the National Aids Control Organisation (NACO) will press

them to make insurance " inclusive and universal for PLHIV " .

Currently, HIV is excluded from all insurance policies available in the country

" violating the national mandate of providing stigma free care and support

services " .

Union health ministry officials said that HIV/AIDS which was earlier regarded as

a " incurable disease " has now become a " manageable health problem " and,

therefore, should be included in medical insurance policies.

" Right now, there are individual health schemes in some states which cover

certain healthcare related costs of PLHIV. Many health insurance policies

exclude services to PLHIV and there is need for a package designed specially for

such people. We will discuss global best practices to see how a viable insurance

policy can be created for them, " joint secretary Aradhana Johri told TOI.

Another ministry official said, " Those living with HIV are living longer and

have less morbidity cases, thanks to the increase in anti-retroviral therapy

(ART) coverage. With timely initiation of ART, PLHIV may live a normal life up

to 20 more years. Companies need to realize that covering HIV patients with a

medical policy is no more a loss making proposition. "

India with a HIV prevalence rate of 0.31% is home to the third largest number of

people living with HIV/AIDS in the world -- 23.9 lakh.

Some countries with higher prevalence rates of HIV have already taken measures

to mainstream HIV through commercial health insurance cover. These include South

Africa (17.8), Namibia (13.1), Uganda (6.5), Guyana (1.2) and United States

(0.6).

K K Abraham, chief of Indian Network of People Living with HIV, said, " Insurance

is life saving for us. "

At present, only Star Health and Allied Insurance has an insurance policy for

PLHIVs in four states -- Karnataka, Maharashtra, Andhra Pradesh and Tamil Nadu.

More than 7,000 PLHIVs have subscribed to this insurance which provides a health

cover of Rs 30,000 with a yearly premium Rs 1,511.

NACO says that with about 89% of all HIV/AIDS infections being in the 15-49 age

group, it effects in the most productive years. Currently, the financial burden

of treatment and care is shared by NACO and PLHIVs. While NACO pays for ART,

PLHIVs face economic burden of travel, nutrition and loss of wages.

Recently, India launched the national health insurance scheme, Rashtriya

Swasthya Bima Yojana (RSBY), for BPL. It is to be rolled out in 366 districts in

29 states. As on December 23, 2010, a total of 22,354,462 smart cards have been

issued across 260 districts in 27 states.

NACO says, " HIV has been taken out from the exclusion list making it possible

for poor PLHIVs to be covered under health insurance, which can make them

entitled to one time hospitalization for nearly 700 in-patient procedures with

costs up to Rs 30,000 by paying a minimal registration fee of Rs 30 per annum. "

http://timesofindia.indiatimes.com/india/HIV-may-get-medical-insurance-soon/arti\

cleshow/7406401.cms#ixzz1CkGK9b7Z

[Guest guest]

Dear all,

Re: /message/12500

It's a good news for all the PLHIVS that they would be entitled for getting

insurance cover.Better late than never, one can say..The implementation of the

present STAR health insurance available in Maharashtra for the PLHIVs needs to

be looked into. Mostly it the network of positive people who are promoting it.

One Vada- paav vendor in Uran had chronic Dyspepsia.Abdominal Kochs was ruled

out after all the basic invetigations including USG abd. He was convinced by

the raigad positive network to avail the policy ( CD4- 400)to " get rid of " his

chronic abdominal pain.

Aftr paying the first premium, he got admitted in Dr. D.Y. Patil hospital,

Nerul. He was there for a week.There he was rescreened for Kochs. Later, they

did his gastro-oesophagoscopy. Mild inflammatory changes was the diagnosis. He

was discharged with a prescrition of OMEZ and Gelusil. His bill was 12,000/- out

of witch only 5000 was reembursed.

The client was a nervous wreck. It seems 'Scopies'are not coverd by Star.

policy. Now who is supposed to clarify this to the innocent policy seekers?

Also, Why not make some important amendments by adding the treatment cost of MDR

T.B.?

Dr. Divya Mithel

e-mail: <d_mithel@...>

[Guest guest]

Dear FORUM,

/message/12501

Five years back many companies come forward to provide insurance. Most of them

where after media coverage. 

However, there are several issues about insuring people living with HIV. Such as

who will pay the installments, after the death of PLHIV who will follow

the dispersement procedure of insured money to the family of PLHIV?

Even in Health insurance the reimbursement of the money to the patient after the

treatment is big issue, because there is lot of documentation and lengthy

process at all levels.

 

I am dealing with many cases in consumer courts as well as High Court for the

claim of patient or their family members where Insurance companies do not pay

their dues for years or wants to delay the case of payment.

 

Personally I feel this is an exercise of facelift of NACP by NACO to show

concern only on paper.

I observed while working in this sector, that many implementing authorities are

not even sensitive on rights of infected / affected people living with HIV/AIDS.

There is no correctional mechanism at all.

Incidently some of the health care scams are also giving us confidence such as

the insurance sector scam in US

U.S. HEALTH CARE SCAM BAILOUT FOR INSURANCE RACKETEERS

http://foreclosureblues.wordpress.com/2010/11/14/u-s-health-care-scam-bailout-fo\

r-insurance-racketeers/

 

Top ten Scams in India

http://indianblogger.com/top-10-financial-scams-in-india/

 

Kindly think again about the detail of the proposed insurence programme for

people living with HIV.

Best wishes

Avnish

Avnish Jolly,

#3008,Sector-20D,

Chandigarh 160020, India.

Cell: +91-9814213809

[Guest guest]

Dear forum members ,

Re: /message/12501

 

Greetings from Nellai Sutram , (Federation of support groups of People Living

with HIV )Tirunelveli District

 

We are heartly welcome the medical insurance  . Thanks to NACO for the good

intiative .

 

At the same time , we have to seriouly looked the matters what Dr. Divya Mithel

explained to the forum.

 

We are not blame any one. But we should educate the PLHIV regarding  insurance

and claim procedure and the same time in the hospital also.

 

And friendly oriented access of schemes will be needed for the betterment of

PLHIV who are in marginalsied.

 

Definetly , we have prepared the PLHIV on medical insurance in  our district and

ensure the enrollement in the medical insurance future.

 

With regards

 

Mr.Alagar,

President,

Nellai Sutram

e-mail: <nellaisutramtvl@...>