DEF­I­NI­TION

Weekend Argus (Saturday Edition) - - PERSONALFINANCE -

CD4 count: A mea­sure of the CD4 cells in a drop of blood. CD4 cells are one of a num­ber of types of blood cells that make up the im­mune sys­tem. Th­ese cells are at­tacked by HIV. Peo­ple not in­fected with HIV have be­tween 700 and 1 000 CD4 cells in a drop of blood.

The govern­ment gives an­tiretro­vi­ral treat­ment to peo­ple when their CD4 count drops to 350.

Al­lLife has a dis­pute res­o­lu­tion mech­a­nism that in­volves the South African HIV Clin­i­cians So­ci­ety, but it has not had to use the mech­a­nism de­spite of­fer­ing life poli­cies to peo­ple with HIV since 2005, Beer­man says.

Al­lLife helps peo­ple with HIV to re­main healthy by re­mind­ing them how to stay healthy, in­clud­ing when to go for their blood tests (at least ev­ery six months). As long as pol­i­cy­hold­ers man­age their health, all they must do to prove ad­her­ence is give per­mis­sion up­front for Al­lLife to re­ceive their med­i­cal in­for­ma­tion, he says.

Da­lene Allen, un­der­writ­ing man­ager at Al­tRisk, says it has never de­clined a claim for fail­ure to ad­here to a treat­ment pro­gramme since it started of­fer­ing cover in 1999. A re­port from a treat­ing doc­tor is all that is re­quired to prove ad­her­ence, she says.

CHRONIC ILL­NESS LOAD­ING

Peo­ple with HIV who take out San­lam’s “nor­mal” pol­icy will have their pre­mi­ums loaded, as is the case for any­one who has a chronic ill­ness when they take out life cover.

The load­ing is ap­plied on a slid­ing scale, de­pend­ing on the stage of the dis­ease, whether or not the pol­i­cy­holder is man­ag­ing the dis­ease well and/or has any com­pli­ca­tions, Coet­zer says, and it is there­fore “more se­cure and less of a has­sle”.

Allen says Al­tRisk’s pre­mi­ums are most favourable for peo­ple who are mem­bers of a med­i­cal scheme and there­fore have ready ac­cess to the an­tiretro­vi­rals and the spe­cialised health­care they re­quire.

San­lam may de­cline to cover some peo­ple with HIV, just as it may de­cline cover to some peo­ple with other chronic ill­nesses. Gen­er­ally, those who can il­lus­trate that they ap­proach their dis­ease man­age­ment re­spon­si­bly will qual­ify, Coet­zer says.

Those de­clined will still be able to ap­ply for a pol­icy that mon­i­tors ad­her­ence to treat­ment.

Beer­man says Al­lLife’s poli­cies are likely to be avail­able to a broader range of peo­ple, be­cause it pro­vides cover to in­di­vid­u­als with a CD4 count as low as 200. The amount of life cover is also not limited.

He says peo­ple with HIV can get cover from Al­lLife within 45 min­utes, whereas ob­tain­ing cover on a stan­dard life pol­icy will re­quire sub­mis­sion of a CD4 count and may re­quire a range of med­i­cal tests be­fore you re­ceive a quote.

Coet­zer says San­lam can of­fer peo­ple with HIV nor­mal life cover be­cause in­ter­na­tional and lo­cal re­search has shown that HIV is now a man­age­able dis­ease if it is treated timeously and prop­erly. Lo­cal data has en­abled San­lam to as­sess the risks in­volved, he says.

The re­search ap­par­ently shows that peo­ple liv­ing with HIV who fol­low rec­om­mended treat­ment pro­to­cols timeously, can have a life ex­pectancy equal to 80 per­cent of that of an HIVneg­a­tive per­son of the same age.

Sec­tion 27, a hu­man rights or­gan­i­sa­tion, re­cently raised con­cerns that the blan­ket de­nial of cover by most in­sur­ers for those who are HIV pos­i­tive was dis­crim­i­na­tory.

San­lam does not not of­fer dis­abil­ity cover to peo­ple with HIV. Al­lLife does of­fer dis­abil­ity cover, and Al­tRisk of­fers crit­i­cal ill­ness cover, im­pair­ment cover and in­come re­place­ment on im­pair­ment.

The max­i­mum as­sured amount on San­lam’s nor­mal poli­cies for those who are HIV- pos­i­tive is R5 mil­lion, while HIV- neg­a­tive pol­i­cy­hold­ers en­joy un­lim­ited cover, but Coet­zer says this may be re­viewed in fu­ture.

Al­tRisk’s max­i­mum for peo­ple with HIV is R4 mil­lion and Al­lLife has no max­i­mum.

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