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The definition of AIDS includes several diagnoses with and without HIV positivity. The services that are directly attributed to these specific diagnoses are paid for through special risk reinsurance. These diagnoses include:

  • Candidiasis of esophagus, trachea, bronchi, or lungs
  • Cryptococcosis, extrapulmonary
  • Cryptosporidiosis with diarrhea in indivduals older than one month
  • Cytomegalovirus disease in organs other than liver, spleen or lymph nodes in individuals older than one month
  • Kaposi's sarcoma in indivuduals younger that age 60
  • Lymphoma of the brain (primary) in individuals younger than age 60
  • Mycobacterium avium complex/M. Kansasii disease, disseminate
  • Pneumocystis carinii pneumonia
  • Progressive multifocal leukoencephalopathy
  • Toxoplasmosis of the brain in individuals older than one month
  • Herpes simplex virus with an ulcer lasting longer than one month or herpes simplex virus with bronchitis, pneumonia, or esophagitis in individuals older than one month

Additional diagnoses associated with AIDS require a positive HIV test in order to be covered under the special risk reinsurance pool. These diagnoses include:

  • CD4 T-lymphocyte count less than 200
  • Recurrent pneumonia, more than one episode within one year
  • Invasive cervical cancer
  • Coccidiomycosis, disseminated
  • HIV encephalopathy
  • Histoplasmosis, disseminated
  • Isosporiasis with diarrhea more than one month
  • Non-Hodgkin's lymphoma
  • Tuberculosis
  • Recurrent salmonella septicemia
  • HIV wasting syndrome
Last Updated: 07/01/2024