More as­sur­ers now treat­ing peo­ple with HIV like those with other chronic dis­eases

Tips for tak­ing out cover if you are HIV+

Weekend Argus (Saturday Edition) - - PERSONALFINANCE - LAURA DU PREEZ

South African life as­sur­ers are fi­nally ac­cept­ing that HIV/Aids should be treated in the same way as any other chronic ill­ness, such as di­a­betes or high blood pres­sure.

This week, ahead of World Aids Day tomorrow, Old Mu­tual an­nounced that it will ac­cept peo­ple with HIV on both its Life­Plan and Greenlight poli­cies; Lib­erty an­nounced it will al­low peo­ple with HIV to take out cover against death on its Life­style Pro­tec­tor poli­cies; and Al­tRisk an­nounced it is scrap­ping the re­quire­ment that qual­i­fy­ing clients with HIV must com­ply with an­tiretro­vi­ral treat­ment in or­der to en­joy ben­e­fits on its poli­cies.

In Au­gust, Sanlam took the lead among the large life as­sur­ers, of­fer­ing “nor­mal” cover against death of up to R5 mil­lion to HIV-pos­i­tive peo­ple.

Un­til then, peo­ple with HIV could ac­cess only poli­cies that re­quired proof of on­go­ing ad­her­ence to treat­ment.

Lib­erty is fol­low­ing suit, but Old Mu­tual is ex­tend­ing not only its death cover, but also its dis­abil­ity and se­vere-ill­ness cover to those who are HIV-pos­i­tive, with only a load­ing for the ill­ness, sim­i­lar to the load­ings that are ap­plied for other chronic ill­nesses.

Al­tRisk was one of the first as­sur­ers to of­fer death, dis­abil­ity and se­vere ill­ness cover to peo­ple with HIV, but the cover was sub­ject to a clause that re­duced the pol­icy ben­e­fit to 10 per­cent of the as­sured amount if, at claims stage, the as­surer found the pol­i­cy­holder had not been com­ply­ing with his or her treat­ment.

As of next week, Al­tRisk will be of­fer­ing new poli­cies to peo­ple with HIV based on their com­pli­ance with an ex­ist­ing treat­ment pro­gramme and with­out the threat of a re­duced ben­e­fit if the pol­i­cy­holder does not con­tinue to com­ply with treat­ment.

Al­tRisk’s spe­cial­ist risk con­sul­tant, Da­lene Allen, says the com­pany’s 14 years of data on HIV-pos­i­tive pol­i­cy­hold­ers shows that th­ese pol­i­cy­hold­ers do com­ply with their treat­ment pro­grammes. It is there­fore no longer nec­es­sary for the com­pany to of­fer cover sub­ject to com­pli­ance to There are a few things peo­ple who are HIV-pos­i­tive should watch out for when tak­ing out life cover, Da­lene Allen, un­der­writ­ing man­ager at Al­tRisk, says. Th­ese are:

◆ Make sure the cover is for the whole of your life, as some in­sur­ers of­fer cover that is only for a cer­tain term. Ini­tially, life cover for peo­ple with HIV was only of­fered on a term ba­sis.

◆ Check whether the cover is sub­ject to pro­vid­ing proof of on­go­ing com­pli­ance with a treat­ment pro­gramme.

◆ Check whether you can ac­cel­er­ate your cover if you be­come ill and your ill­ness is ter­mi­nal. This may help you to get your fi­nan­cial af­fairs in or­der – for ex­am­ple, pay­ing off debt – be­fore you die.

◆ Get an up­front in­di­ca­tion of what the pre­mium is likely to be be­fore you go through all the trou­ble of the med­i­cal un­der­writ­ing, as it may not suit you.

◆ Check whether you can get cover for all your needs: death, dis­abil­ity, se­vere ill­ness and tem­po­rary dis­abil­ity. a treat­ment pro­gramme, she says.

How­ever, Al­tRisk pol­i­cy­hold­ers who are will­ing to prove ad­her­ence to treat­ment ev­ery two years, will en­joy a dis­counted pre­mium.

A dis­count of any­thing be­tween 25 per­cent and 75 per­cent of the loaded por­tion of the pre­mium will ap­ply and the dis­count will re­main in place for two years. To con­tinue to en­joy the dis­count, a pol­i­cy­holder will be re­quired to sub­mit proof of com­pli­ance with treat­ment again.

Allen says ex­ist­ing pol­i­cy­hold­ers who are re­quired to ad­here to a treat­ment pro­to­col can ap­ply for new poli­cies. Th­ese new poli­cies will have re­duced premi­ums. She says Al­tRisk has re­duced the premi­ums on its cover for peo­ple with HIV three times over the past 14 years.

There are no spe­cific lim­its on Old Mu­tual’s cover against death, dis­abil­ity and se­vere ill­ness, and the amount of cover will be de­pen­dent on each in­di­vid­ual’s mer­its.

Dr Peter Bond, the chief med­i­cal of­fice at Old Mu­tual, says peo­ple with HIV will be able to take out ei­ther a Life­Plan pol­icy or a Greenlight pol­icy. The Life­Plan pol­icy is not fully un­der­writ­ten, while the Greenlight pol­icy is un­der­writ­ten.

Un­der­writ­ten cover in­volves an­swer­ing more med­i­cal ques­tions and hav­ing cer­tain med­i­cal tests, and, be­cause of this, is gen­er­ally cheaper than par­tially un­der­writ­ten or nonun­der­writ­ten cover.

Bond says Old Mu­tual’s de­ci­sion to open up its cover means that peo­ple with HIV will get far more ex­ten­sive cover, in­clud­ing cover for se­vere ill­ness and dis­abil­ity.

Lib­erty, like Sanlam, is of­fer­ing cover for death to peo­ple with HIV but only up to R5 mil­lion.

The life as­suer is also mak­ing its Ed­u­Ca­tor ben­e­fit avail­able to peo­ple with HIV, to en­sure that chil­dren can con­tinue with their ed­u­ca­tion even af­ter the death of their par­ents.

Bond says South Africa has now had a suc­cess­ful HIV treat­ment pro­gramme for five years and the data shows that those on treat­ment ad­here to it and their life ex­pectan­cies are quite good.

He says Old Mu­tual will also of­fer cover to those who are not yet on treat­ment if their CD4 count (CD4 cells are blood cells in the im­mune sys­tem that are attacked by HIV) is above the level at which South Africans are en­ti­tled to en­ter the gov­ern­ment treat­ment pro­gramme for HIV.

Peo­ple with HIV will need only sup­ply their lat­est CD4 count and a re­port from their treat­ing prac­ti­tioner when ap­ply­ing for cover with Old Mu­tual. In this way, they will be treated the same as some­one with asthma or di­a­betes who is sent for tests on ap­ply­ing for cover and not hav­ing to be tested af­ter be­ing ac­cepted for cover.

For the Life­Plan prod­uct, they will only need to an­swer some spe­cific ques­tions and sup­ply their lat­est CD4 count.

Old Mu­tual will use med­i­cal ques­tions, re­ports and test re­sults ob­tained when you ap­ply for cover to de­ter­mine how well you are man­ag­ing your disease, and this will de­ter­mine the load­ing that will be ap­plied to your premi­ums, Bond says.

Th­ese load­ings can, how­ever, make a big dif­fer­ence to your premi­ums.

Allen says a R150 pre­mium can buy an HIV neg­a­tive 30-year-old man with a good risk pro­file (no chronic ill­nesses), cover of R2.2 mil­lion. How­ever, a man of the same age who is HIV-pos­i­tive would get only R1.1 mil­lion in cover for the same pre­mium.

Lib­erty says ad­vances in the treat­ment of HIV mean that peo­ple are able to live with the con­di­tion as one would with any other chronic ail­ment such as di­a­betes and they should not have to prove on­go­ing com­pli­ance with treat­ment pro­grammes.

“At Lib­erty, we don’t be­lieve it is ap­pro­pri­ate for peo­ple to lose their cover if they can no longer ad­here to their treat­ment regime, as their need for life cover is com­pletely sep­a­rate from their abil­ity to ad­here to a treat­ment regime or their body’s abil­ity to re­spond pos­i­tively to treat­ment,” Ni­cholas van der Nest, divi­sional di­rec­tor of risk prod­ucts at Lib­erty, says.

“We be­lieve a less puni­tive and dis­crim­i­na­tory ap­proach is what is needed, and we have adapted our prod­uct of­fer­ing ac­cord­ingly.”

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