HIV patient denied access to health insurance

Posted at 05/04/2012 11:09 PM

MANILA, Philippines – A man diagnosed with HIV has revealed how his healthcare provider ended his insurance coverage because he had the virus.

“Carlo” (not his real name) rushed to the hospital when he discovered an infection near his private parts.

His doctor ordered him to undergo surgery immediately and that's when he admitted that he had HIV.

“Sinabi ko sa kanya na, ‘Doc, positive ako.’ Kailangan protektahan ko rin ‘yung doktor, kasi maghahawak sila ng dugo ko, pati mga nurse. Tinanong ko sa kanya kung related ba ‘yung pagiging HIV positive ko sa infection, sabi niya hindi kasi lahat naman tayo nagkakaron ng nana,” he said.

But after the operation, Carlo's health maintenance organization Cocolife called and said they would not cover the almost P50,000 hospital bill he incurred because his insurance does not cover sexually transmitted diseases.

Carlo's doctors earlier certified that his infection had nothing to do with HIV.

“’Yung HMO tumawag sa cellphone ng nanay ko, sabi nila, ‘Misis, hindi po namin ico-cover ‘yung anak niyo kasi sinabi ng doktor na positive siya,’” said Carlo.

After a few months, Cocolife terminated Carlo's 8-year membership, with no explanation.

“Nagulat kami kasi ‘di namin inaasahan. Wala naman kaming sinabi na dahil ‘di niyo kami cinover papaputol na namin. Biglang nagpadala na lang sila sa nanay ko na wala na kong HMO, ‘di na ko covered,” Carlo said.

ABS-CBN News tried to get the side of Cocolife on the matter, but the company refused to give a statement.

The AIDS law said no one should be denied life, health, or accident insurance just because they have HIV.

Insurance companies are also not allowed to terminate insurance coverage, because of the disease.

A medical expert on HIV said such cases are often the rule, rather than the exception.

“Maraming tao ang reluctant talaga na makipaglaban, unang-una, dehado ka na kasi kalaban mo napakalaking kompanya. Number 2, mae-expose ka sa buing mundo. Pero ‘yun ay isang injustice,” Dr. Edsel Salvana, research asst. professor of the National Institute of Health.

The last time government checked on the operations of health maintenance organizations was 16 years ago.

This kind of system makes the public vulnerable to abuse, especially the people with HIV who are more afraid of fighting for their rights, compared to the rest. -- ANC