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Investigation: Insurance Companies Denying, Limiting Coverage to HIV Prevention Drug

California insurance companies have been warned they can’t discriminate against customers who use HIV-prevention medications.

A new state investigation found that some life and disability insurance companies have denied or limited coverage to HIV-negative consumers who use medication like Pre-exposure prophylaxis or PrEP, which is used to prevent contracting the virus.

Under California law, a person’s history of using HIV prevention protocols, such as PrEP, cannot be used as a justification to charge higher premiums or reject customers altogether.

But State Senator Scott Wiener says the issue of insurance companies denying this type of coverage has been a longstanding issue.

“We’ve heard about this from around the country and it’s definitely illegal in California,” he says.

Wiener says from an insurer’s perspective, someone being on the medication should be seen as a good thing, especially because that person presents a lower risk of contracting HIV.

“PrEP is a critical part of our effort to reduce and ultimately end HIV infection – and the last thing we should be doing is punishing people for taking PrEP by denying them insurance coverage,” he says.

Janice Rocco of the California Department of Insurance says the state insurance commissioner has put the companies on notice.

“So insurance commissioner Ricardo Lara just issued a notice to all of the life insurers, long term care insurers and disability income insurers doing business in California to remind them of this longstanding law and to make clear that they need to be following the law or the department would need to take enforcement action against those insurers,” says Rocco.

Several insurance companies contacted by KQED declined to comment.

Copyright 2019 KQED