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The Challenge Of Accessing Life Insurance When You're Living With HIV

Jennifer Jako has been living with HIV for more than half her life. She says she's never been able to get life insurance.

Jennifer Jako has been living with HIV for more than half her life. She says she's never been able to get life insurance.

Kate Davidson/OPB

Prudential Financial recently announced a big change: It will sell individual life insurance polices to people who are HIV-positive.

When she heard that, Portlander Jennifer Jako got excited.

She’s been turned down for life insurance before, most recently when she was pregnant with her daughter, who’s now 9 years old and HIV-negative.

Jako has been HIV-positive for 24 years; she was infected as a teenager. She’s never been able to get life insurance.

“I think that felt like an injustice to me,” she said. “Because we now know that those of us living with HIV, with our virus under control, we’re probably going to live into our 70s. It’s really hard knowing that prognosis and having the paperwork being so far behind.”

Now, one of the country’s major insurers basically agrees.

“We treat people with HIV now the same way as we treat people with coronary artery disease or some other type of long-term chronic illness,” said Mark Hug, executive vice president for products and marketing for Prudential’s Individual Life Insurance division.

“Prior to this, if you had an application and we found out you were HIV-positive, either through a blood test, or if you admitted it on the application, you were immediately declined for life insurance,” he said.

Prudential is believed to be the first major insurer to publicly offer traditional individual life insurance plans to eligible people with HIV. Those are different from group life insurance policies offered by some employers, whose coverage often ends when a job does. Advocates for people living with HIV/AIDS applauded the move.

The turnaround is a dollars-and-cents recognition that HIV is no longer an immediate death sentence. With treatment, some people with HIV can live so long that it’s now profitable to bet on their survival.

OPB asked Prudential to share its underwriting standards for applicants who are HIV-positive, to see how restrictive they are.

It turns out, Jennifer Jako still doesn’t qualify.

That’s because one of Prudential’s requirements is that an applicant’s CD4 cell count can’t ever have fallen below 200 cells per cubic millimeter. A CD4 count measures a type of white blood cell that helps protect the body from infection. Falling below 200 cells per cubic millimeter is an indication that HIV infection has progressed to AIDS.

According to the Centers for Disease Control and Prevention, people are diagnosed with AIDS when their CD4 cell count falls below 200, or if they develop certain opportunistic diseases.

Jennifer Jako says she received an AIDS diagnosis years ago, when her CD4 count fell below 200. Then, she was put on new medication. Her viral load was suppressed; she says it’s been undetectable for nearly 18 years. Jako’s last CD4 count was 752 cells per cubic millimeter.

But for insurance purposes, that AIDS diagnosis can’t be undone.

An estimated 1.2 million people in this country are living with HIV. The CDC says that, as of 2013, more than half a million had been diagnosed with AIDS at some point.

Prudential says its guideline is based on studies showing that people with CD4 counts below 200 have lower survival rates as a group than those with CD4 counts of 200 or more. Relaying information from Mike McFarland, chief underwriting officer of Prudential Individual Life Insurance, spokeswoman Janet Gillespie said Prudential may be able to offer life insurance to people like Jennifer Jako in the future.

Meanwhile, Jennifer Jako acknowledges that many people living with HIV will benefit from Prudential’s life insurance offering — just not people like her who’ve come back from the brink.

“Actually, I think I’m probably going to be a 70- or 80-year-old grandmother with white hair at some point,” she said, laughing. “And I look forward to that. But I probably will not have life insurance.”

You can hear Jennifer Jako’s conversation with OPB All Things Considered host Kate Davidson by clicking the audio player above.

About Prudential’s Life Insurance Rules For People With HIV

People living with HIV are now eligible for 10- and 15-year convertible term life insurance policies from Prudential Financial, in cooperation with AEQUALIS. “Convertible” means the policy can be switched to permanent coverage for life at any point during the original plan. Prudential’s Mark Hug says the death benefit ranges from $100,000 to $2.5 million.

Below are the underwriting criteria provided by Prudential:

  • Age 30 to 60 years at time of application submission.
  • Lowest ever recorded CD4 count greater than 200 and no history of AIDS-defining condition.
  • More than 1 year since HIV diagnosis and, if being treated, greater than 6 months since current Antiretroviral Therapy (ART) initiated.
  • CD4 count and viral load recorded within 6 months from time of application.
  • CD4 count 350 or greater when last measured.
  • Viral load is less than 200 copies/mL.
  • Free of Hepatitis B.
  • Free of Hepatitis C.
  • Free of TB or Non-TB mycobacterial infection.



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