Home Healthcare Use of HIV Prevention Drug Could Lead to Insurance Denials

Use of HIV Prevention Drug Could Lead to Insurance Denials



If you have ever applied for insurance coverage – whether life, disability, or health – the insurance agent has pages of questions that he or she will pose to you.  Those questions cover medical history, family history, employment history – anything that could provide the insurance company insight into what sort of health issues you have had or may have, and thereby give them more information on which to base the decision regarding whether to insure you and for how much.

Sometimes, these questions are followed by a blood test, which is used to confirm your answers and check for other issues of which you may not be aware.  “Any abnormal result could result in your being denied insurance coverage – even if you aren’t aware of the issue or condition,” said J. Price McNamara, a Louisiana Insurance Attorney with the Law Offices of J. Price McNamara.  “On the other side, insurance companies will offer discounts to individuals who live a healthy lifestyle or take advantage of offered examinations.”

The idea of taking preventative steps to maintain your health neatly dovetails with the ability to obtain cheaper insurance coverage.  However, the use of Truvada (the brand name of the combined dose of emtricitabine and tenofovir) – a pre-HIV-exposure prophylactic medication – has recently cause many gay men to be declined health and life insurance coverage.

The medication has two uses: it is used in the treatment of individuals who are HIV-positive to try and control the spread of the virus, and it is used by individuals who are at high-risk of HIV exposure to try and prevent infection.  The drug has been shown to be highly effective against contracting HIV and is regularly used by gay men and sex workers.

Clearly, the use of Truvada by high-risk populations is preventative, just like the use of any other prophylactic.  However, because the medication shows up in blood tests and because it is also used to treat HIV – not just prevent infection – it may first appear to an insurance company that an individual is treating an undisclosed infection.  Failure to disclose certain illnesses to an insurance company often results in a denial of coverage.

But what if you are using the drug to help prevent the possibility that you are infected with HIV?  Should this be an indication that you engage in risky behavior or that you actively try and control your health?  Additionally, because HIV is so prevalent in the gay community does the denial of coverage because of the use of the drug discriminatory?

Many LGBTQ advocates believe that this is a matter that must be confronted head on, as allowing insurance companies to deny coverage to individuals because of a proactive step in managing one’s risk may simply lead to a decline in the usage of Truvada in the interests of insurance coverage, which will undoubtedly negatively impact members of the gay community.

If you have been declined coverage because of your use of Truvada as a pre-exposure prophylactic (PrEP), contact an experienced insurance attorney to advise you of your rights and help you fight the insurance company for the coverage you deserve.


Sign up for the Blue Virginia weekly newsletter

Previous articleLet this be the death of flag lowering.
Next articleTuesday News: “In farewell statement, McCain takes one last swing at Trump”; Trump Tries to Reach Mexican President Enrique Peña Nieto on Speaker Phone; “Trump Is Nuts. This Time Really Feels Different”