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First-ever lawsuit filed against insurance company who refused coverage of gay man for using PrEP

In a first of its kind case, a lawsuit has been filed by the Gay and Lesbian Advocates and Defenders (GLAD) against Massachusetts Commission Against Discrimination (MCAD), claiming that the insurance company Mutual of Omaha allegedly denied health coverage to man because he is taking the HIV preventative drug Truvada, or PrEP.

John Doe, as he is being named on the complaint says that he applied for insurance through Mutual of Omaha and stated on the application that he was actively using the drug to prevent acquiring the deadly disease.

Truvada has been approved by the Food and Drug Administration since 2004 where it was used to help the treatment of HIV. However, in 2014 the medication was also approved as a daily treatment as a preventative for the transmission of HIV.

The 61-year-old Doe says that he saw first-hand what the epidemic did to the community and its people and he simply wants to eradicate the disease proactively.

“I was being responsible and doing the right thing,” said Doe. “Insurance companies should be begging everyone to take Truvada – not discouraging them. As someone who lived through the worst of the epidemic and saw dozens of my friends die, I want to do everything I can to stop it.”

The plaintiff said that he needed extended health care insurance and chose to apply to Mutual of Omaha for such coverage in late 2014.

However, the insurance giant, in their February 2015 rejection letter to him, stated that they would not be able to provide service because he admitted to taking Truvada as PrEP.

Mr. Doe quickly filed an appeal, but once again the company re-iterated their stance and declined to accept him as a client.

Bennet Klein, Senior Attorney and AIDS Law Project Director at GLAD says that the irony in the company’s denial is in their policy itself.

“Mutual of Omaha’s denial is nonsensical,” he said. “If our client were not taking Truvada, not protecting his health and the health of others, he would have received the insurance. We should be well beyond the days when insurers make decisions based on fear and stereotypes about HIV. The assumption is that gay male sexuality is inherently risky and unhealthy, and that’s just wrong.”

GLAD’s claim against MCAD is that Mr. Doe was illegally denied service based on his sexuality and perceived disability, and that Mutual of Omaha is in violation of anti-discrimination laws that protect individuals from adverse treatment based on incorrect judgments about LGBT people and health care.

About GLAD: Through strategic litigation, public policy advocacy, and education, Gay & Lesbian Advocates & Defenders works in New England and nationally to create a just society free of discrimination based on gender identity and expression, HIV status, and sexual orientation.

Timothy Rawles is Community Editor of SDGLN. He can be reached at editor@sdgln.com, @reporter66 on Twitter, or by calling toll-free to 888-442-9639, ext. 713.