12:03, August 05 97 0

2017-08-05 12:03:06


Insurer is sorry it used ‘insensitive language’ when denying PrEP coverage

This past Thursday, an HIV/AIDS activist posted a letter from July in which United Health Care (UHC) denied coverage for PrEP because the patient was going to engage in “high risk homosexual behavior.” That same day, UHC announced that it was ending its pre-authorization requirements for PrEP, making it easier for patients to access the medication.

PrEP, or pre-exposure prophylaxis, refers to the use of medication like Truveda in order to prevent transmission of HIV. PrEP has been shown to be 99% effective in preventing the transmission of HIV if taken every day. As activist Mark King noted on LGBT Nation, “high risk homosexual behavior” is a sign that someone needs PrEP, not a reason to deny coverage.

On July 1, UHC started a policy to restrict coverage of the drug, requiring doctors to get authorization for the prescription every three months and for patients to fill their prescription by mail instead of at any pharmacy.

The authorization form itself was also controversial. “It asks if you are gay, straight or bisexual,” doctor Andrew Pavlatos told the Windy City Times. “Who the hell cares? If you’re at risk, you’re at risk—your doctor determines that.” Pavlatos said that he believes the question violates the Affordable Care Act, which bans discrimination in health care coverage.

In a statement, UHC apologized for the “insensitive language” in the letter. “We have corrected our letters, removed the prior authorization requirement for Truvada and members can fill their prescription at the network pharmacy of their choice. This is effective immediately.”

UHC did not explain why coverage was denied to the unnamed gay man who received the letter that went viral, or whether people who engaged in “high risk heterosexual behavior” were similarly denied coverage.

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