Insurance Company Axes PrEP Coverage, Then Reverses Decision

When we said yesterday “when the money stops, everything stops,” we were referring to banks’ and credit card processors’ rules for porn purchases. Today, it’s not the banks but insurance company Assurant Health putting on the financial brakes, and not on porn, but on PrEP.

Assurant Health is a Wisconsin-based provider specializing in individual and small business health care plans. The Milwaukee Journal Sentinel first reported on the company’s plan to be “sold off or shut down.” The article states that both an industry insider and company executives place the blame for their financial woes on the Affordable Care Act — specifically the provisions that prevented the denial or cancellation of policies due to pre-existing conditions. In other words, “Thanks, Obama.”

For the rest of us who mean it when we say “Thanks, Obama,” ABC news revealed that the House Committee on Energy and Commerce discovered that Assurant Health, along with WellPoint Inc. and United HealthGroup “canceled nearly 19,800 customer policies between 2003 and 2007.” They say it was to “combat insurance fraud.” The committee felt otherwise:

“These practices reveal that when an insurance company receives a claim for an expensive, life-saving treatment, some of them will look for a way, any way, to avoid having to pay for it,” subcommittee chairman Rep. Bart Stupak, D-Mich., said at the hearing.

Yesterday, Poz.com published a letter an Assurant Health member received specifically about his Truvada prescription. But days numbered or not, Assurant Health has drawn a line in the sand: After July 1, 2015, they will only cover Truvada if it’s being used “in combination with other antiretroviral agents” to treat HIV-1 infections and not for “preexposure prophylaxis,” aka PrEP.

But then, immediately following the shitstorm stirred by Poz.com’s piece, the company decided to change its mind. As Frontiers reports, Assurant VP Mary Hinderliter issued a statement already saying “We are reversing our decision and will be reaching out to policyholders who received the letter.”

This is good news and a good precedent when it comes to PrEP coverage nationwide, moving forward.

PrEP is something just about everyone has an opinion on. We also ran an article this week about Seth Fornea and PrEP and in the comments section, he shares his feelings on the matter with detailed eloquence. What is not an opinion, but reported by the New York Department of Health, is that the cost of Truvada medication alone is “between $8,000 and $14,000 per year.” While you can’t put a price tag on health, that is a tidy sum to come out of pocket.

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As published in Poz.com, the letter from Assurant Health to their members on Truvada:
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One look at the pros and cons of PrEP

 
 
And a thank you, Mr. President

 

10 thoughts on “Insurance Company Axes PrEP Coverage, Then Reverses Decision”

  1. Dunno why it’s so expensive in the US. I take Truvada, non-generic, and it costs me $500 a year. Not covered by insurance, but i don’t mind. Your pharmaceutical companies are milking you…

  2. Maybe if the ACA had done something to actually control costs and finally attack the drug industry for outrageous pricing in the US Congress granted them back in the 60s we’d see some differences. While it is great nobody can be denied coverage, the harsh reality is if you live in a state dominated by the Blues and restrain competition with their protected hospital discounts, things would change. Affordable healthcare at $8000/year for a basic plan that once you earn $1 OVER the 4x poverty limit is a shocker for most Americans.

    I read that when the new Hep C drug came out, $84,000 here in the US – about $800 in Eqypt for the same damn medication and that is a CURE!

    Maybe insurance companies should be allowed to import these drugs from foreign countries and lower cost/lower premiums? Nah, that would require Congressional approval and their health plan coverage will NEVER be what the average American gets.

  3. I don’t get like everyone else is saying why not use a condom? This isn’t a cheap drug like a birth control that’s maybe ~20$ this is thousands of dollars. Like hello? So you want the insurance company to pay for your risky sex life? Sorry but no, unless your someone with the illness the insurance company should not cover you.

  4. mister reality

    If I were a for profit insurance company, I’d pass on Truvada too. Screw it. If clients aren’t HIV +, why pay for them to stay that way when there are rubbers? There are people with non-voluntary risks like cancer, muscular issues, tumors, heredetary diseases I’d way rather pay for over Truvada users. Sounds heartless but after eons of fighting to get the word out about safe sex, there is little question that Truvada has created an entitled class of people who don’t think they should be limited at all. That’s fine, but pay for your indulgences. If you trust PrEP with your life, it seems fair to pay up.

  5. God forbid Truvada whores use a condom. The world will end!!! All insurance companies should drop Truvada as a preventative. It’s far too expensive to be spending tens of thousands of dollars on a damn pill just because a bunch of queens think they’re too good for a condom.

    1. Well said. If Truvada is being used as a recreational drug and not to treat disease, those using it should have to pay for it.

  6. I can totally understand why the insurance companies don’t want to pay. Why should they pay so that people can engage in risky behavior, when there is a perfectly acceptable, cheaper alternative (condoms). If people want to use PrEP so that they can have bareback sex, great, but other customers should not have to pay higher premiums so they they can engage in risky behavior without consequence. Not saying anything negative about PrEP, it’s wonderful, just that people shouldn’t expect others to pay for it.

  7. So, you are going to blame this on Obama rather than on the insurance companies who do not want to pay for the drugs?

    1. Joseph, “For the rest of us who mean it when we say “Thanks, Obama,” was not written as sarcasm. That is also why I included the video where President Obama pokes fun at the “Thanks, Obama” nonsense himself. Though I can only speak for myself, I am not the only supporter of the President here at The Sword.

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