In 2005, Shanthamma, 36, walked out of a Bangalore hospital with the body of her 9-year-old daughter who succumbed to AIDS, a new-found HIV-positive status and loads of shock and guilt. She and her husband were shunned by their dearest ones as they thought one could contract HIV just by looking at the infected couple.

Despite the hostility, Shanthamma refused to lead a secluded life and started working with Karnataka Network of Positive People (KNP+). Yyears on, awareness about the virus and the myths and the stigma surrounding it has helped her make peace with her situation. But still, there was a nagging question giving her sleepless nights: “what will I do for the next hospitalisation charges?”

This is when she learnt about StarNet–India’s first ever health insurance policy exclusively for PLHIV launched by Star Health & Alliance Insurance Company Ltd, and Population Services International, with support from USAID in August 2008. A year on, when she talks about the benefits of the policy, it is hard to ignore a new sense of security in her: “If I get hospitalised, at least I have something to fall back on. That takes away a lot of my worries. I have that sense of security now.  I am happy about it.”

This initiative didn’t come easy. For both PSI and Star Health, it took long to chisel a policy that was commercially viable and sustainable for both promoters and policy-aspirants. They tied up with KNP+ and offered it as a group policy with at least 300 aspirants. But the promoters came across some people who were interested in the policy but could not pay the annual premium of Rs 1,511 for Rs 30,000 coverage. PSI decided bear half the premium and the venture took off.

Buoyed by the “tremendous” response to the policy, D Rama, Vice-President, Star Health, Chennai, says: “We are constantly working to improve the package…. We cannot give solutions to all their problems but we are doing everything we can to give them emotional support.”

Fighting stigma & discrimination

In India, the fear of HIV often gets translated into the fear of HIV-positive people. Moreover, a huge segment of the PLHIV comes from the lower-middle class and poor economic background least prepared to face the onslaught of adversities. Apart from the lack of awareness and quality healthcare, the mounting hospital bills also perpetuate the downward spiral of poverty, disease, and job loss. Families shun their dear ones as they cannot bear the health expenditure.  The infected population is thus deprived of the crucial emotional support and sometimes, financial backing, imperative to keep the virus in check.

“We never know when we need hospitalisation. This insurance tackles that uncertainty and brings down the dependence on our families,” says Seema M, 33, district network officer of KNP+, Mangalore.

Seema entered into wedlock with a man who guarded his HIV-positive status almost till his end. He refused to share the information although he was well aware that his wife too had contracted the virus and didn’t budge even after she conceived.  By the time she understood the difference between HIV and AIDS, her husband had passed away and her daughter Sheethal (14) was going to school. Seema remarried another positive person seven years later but he didn’t survive either.

“I didn’t know anything about HIV/AIDS. I suffered only discrimination and except for a few people, even doctors refused to counsel me. I didn’t even understand what was going on.”

Fortunately, things have changed for the better. Seema is now busy counselling people on various aspects of HIV/AIDS and also tries to make them understand the positive features of the insurance cover. “There has been a very good response. Many people are buying the package in Dakshina Kannada district.”

The policy in a nutshell

Eligibility:

• Only HIV-positive people are eligible. No age limit. It is issued to a group of 300 PLHIV. It should be proposed by government agencies, NGOs, societies and other registered bodies. Pre-insurance screening is mandatory.

Policy cover:

• Rs 1511 premium; the premium is inclusive of 12.36% service tax. 50% of the same is borne by PSI. 50% of the premium amount is allocated for hospitalisation and the rest is disbursed at AIDS stage. With this, the individual receives the lump sum and the policy ceases to exist.

Policy exclusions:

• Expenses incurred for ART treatment and TB are not covered. All medical conditions existing prior to the commencement of the cover, except those specifically covered. AIDS confirmed during the first 90 days from commencement of the cover.

Claim procedure:

• Notice to Star Health & Allied Insurance Co. Ltd., within 3 days of admission.

For more details, click here.  To enrol: Call D T Thyagaraj, State Insurance Co-ordinator, KNP+ Bangalore. Ph: 080-23521915/23130409.

(This essay was chosen for ‘Red Ribbon Maathanadidaga’ anthology published by CDL-UNICEF).