Insurance Company Denied Coverage to Gay Man Because He Takes HIV Medication

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Insurance Company Denied Coverage to Gay Man Because He Takes HIV Medication

Jessica Mason Pieklo

A complaint filed with the Massachusetts Commission Against Discrimination accuses Mutual of Omaha of denying long-term care insurance to a man taking HIV medications.

Despite non-discrimination requirements in the Affordable Care Act and other civil rights protections, attorneys with Gay & Lesbian Advocates & Defenders (GLAD) claim that the Mutual of Omaha insurance company discriminated when it denied a gay man long-term care insurance because he is taking HIV medication.

The allegations were made in a claim filed with the Massachusetts Commission Against Discrimination (MCAD). Mutual of Omaha denied long-term care insurance to the plaintiff, identified in the complaint as John Doe, because he is taking Truvada, according to the complaint.

Truvada, a form of PrEP or pre-exposure prophylaxis, is a medication prescribed to HIV-negative people to prevent the transmission of HIV. This is the first lawsuit in the country challenging discrimination against a person on PrEP.

Truvada was first approved by the Food and Drug Administration in 2004 as a treatment for HIV and then again in 2012 as a method of preventing HIV infection. Public health experts applauded the treatment as a major medical breakthrough in HIV prevention that has the potential to end the epidemic.

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The complaint describes how Doe, a Boston man, applied for long-term care insurance with Mutual of Omaha in November 2014. Long-term care insurance pays for some or all of the costs of nursing homes, assisted living facilities, and home health care for people unable to take care of themselves. Long-term care insurance is a common part of end-of-life planning.

Mutual of Omaha first denied Doe’s application in February 2015, openly stating that the reason for the denial was that he was taking Truvada. Doe appealed the denial, but Mutual of Omaha rejected his appeal in April 2015.

“Mutual of Omaha’s denial is nonsensical,” Bennett Klein, senior attorney and AIDS Law Project Director at GLAD, said in a statement. “If our client were not taking Truvada, not protecting his health and the health of others, he would have received the insurance.”

The claim filed with MCAD alleges that Mutual of Omaha illegally denied Doe access to a place of public accommodation based on sexual orientation and on disability. Disability anti-discrimination laws protect those who are treated adversely based on false beliefs about a health condition.

“We should be well beyond the days when insurers make decisions based on fear and stereotypes about HIV,” Klein continued. “The assumption is that gay male sexuality is inherently risky and unhealthy, and that’s just wrong.”

The Centers for Disease Control and Prevention estimates that PrEPs like Truvada can reduce the risk of HIV transmission by up to 92 percent while a study by researchers at Kaiser Permanente San Francisco Medical Center found no new HIV infections among 657 people of PrEP over a two-and-a-half year period.

“I was being responsible and doing the right thing,” the plaintiff said in a statement. “Insurance companies should be begging everyone to take Truvada—not discouraging them.”

Mutual of Omaha has not yet responded to the complaint.