On July 22, 1999, I received a letter stating a question on a claim for billing on an HIV blood test for a 2-year-old. Until records were provided by providers, they would be unable to process claims. 

The records were provided by the doctor stating the child was HIV negative. I then received a call from them on August 24, 1999 saying that I checked off on the application that the child had "no drug addiction". (When I applied for the insurance in November 1998, I discussed on a telephone interview that I took custody of this baby in New York, gave them the name of the hospital in which the child was born to verify his records which told them he had cocaine in his urine. They approved him and the records showed he was NOT neonatal drug addicted). 

August 24, 1999, I faxed them the records showing he was not addicted and a healthy baby. Following that, when the baby was 2 months old, he had viral meningitis. At that time, he was on Medicaid. The viral meningitis was written on the application November of 1998. 

As of now, they will not cover viral meningitis for 2 years, stating that the virus is a pre-existing condition.

1. I asked the doctor for the second HIV test. The first was negative, and so was the natural mother. 

2. They were trying say that I misrepresented the information on the application saying he had "no drug addictions." (He was never treated for any addictions and a perfectly healthy, normal baby.)

3. Viral meningitis is not a recurring illness. It's just something that happens.

 I feel that since I asked the doctor for an HIV test on the baby, which was the second test to prove he was negative (the first test done at 2mo old), that they are trying to rate him or drop him from the plan in some way. 

Every time I proved I did nothing wrong, they looked for something else. They have advised me they will cover everything else except for viral meningitis, which is not chronic. We have outbreaks of this all over the country, especially in FL during the winter. It's an airborne virus which can be contracted by anyone at anytime and any number of times. 

 They okayed this child until I got an HIV test. How can they ok it and turn around 9 months later and start putting in things that they are not going to cover? 

I am in the process of adopting this child. He is a perfectly beautiful, normal, healthy child, which the doctors will testify to. This kind of treatment has got to stop; which means if he catches anything, they could exclude coverage on it.

 Consequences: If this child contracts this virus from another child, such as a school child, it could put me in debt or with no insurance, and would emotionally damage this whole family. 

The stress of not knowing whether your child is insured or not is awful. I feel they are discriminating against any child or person who gets an HIV test. If I had not gotten him retested, I would not have a problem now. They insured him to begin with, with viral meningitis shown on the application.

This typifies what is wrong with our patchwork health care system:  we're afraid to seek treatment or even testing for fear of what the all-mighty insurance company might think about it.

Barbara needs to read her policy carefully and perhaps consult with a local attorney who specializes in health care issues.