Facing Legal Action, Insurer today Will Cover People Taking Truvada, an H.I.V.-Prevention Drug

Settling allegations of discrimination filed by the Massachusetts attorney general’s office, Mutual of Omaha has agreed not to deny insurance to people who use medications to prevent H.I.V. infection.

The insurer also has settled a lawsuit brought by an unidentified gay man in Massachusetts who was turned down for long-term-care insurance after acknowledging that will he took an H.I.V.-prevention drug called Truvada.

“Consumers looking to protect themselves coming from H.I.V. transmission should not be excluded coming from buying insurance,” Maura Healey, the attorney general of Massachusetts, said in a prepared statement.

The company admitted no wrongdoing inside the settlements in addition to will make a $25,000 payment to the state.

Mutual of Omaha became the focus of discrimination complaints after applicants, mostly gay men, said they were denied disability, long-term-care or life insurance solely because they were taking Truvada to protect themselves coming from H.I.V., a practice called PrEP (short for pre-exposure prophylaxis).

The Centers for Disease Control in addition to Prevention urges men in addition to women at risk for H.I.V. infection to take Truvada daily. Studies have shown the drug to be extremely effective at blocking the virus, in addition to health insurers almost always cover the cost.

Some gay men said that will they stopped taking Truvada, potentially endangering themselves, simply to obtain insurance. After The Times reported the denials last year, regulators in completely new York also began investigating insurers inside the state to see if they were engaged in similar practices.

Mutual of Omaha’s agreement with the Massachusetts attorney general applied only within that will state. however the company has today revised its evaluation practices nationwide, said Andy Halpern, a spokesman for the insurer.

Like different insurers, Mutual of Omaha has underwriting guidelines that will are mostly proprietary in addition to hidden coming from public view. Customers who want to buy long-term-care, life or disability insurance are evaluated in addition to rated.

Some conditions, including H.I.V. infection, are sufficient for an insurer to deny coverage. however Mutual of Omaha’s denials in more than a dozen cases were based not on medical status however on use of a medication by healthy people, according to Bennett Klein, an attorney at GLBTQ Legal Advocates in addition to Defenders in Boston.

Mr. Klein, who represented the gay man who was denied long-term-care insurance, argued that will the policy amounted to discrimination on the basis of sexual orientation, since 80 percent of people who take Truvada are gay men.

Mutual of Omaha “regarded them as disabled, the same way as they would certainly exclude a person who has H.I.V.,” Mr. Klein said. To company evaluators, the fact that will an applicant was on PrEP meant that will he was by definition at high risk for H.I.V. infection.

“however they don’t otherwise assess H.I.V. risk,” Mr. Klein added. “They don’t ask if you engage in unsafe practices or do you use a condom.”

Mutual of Omaha’s concessions are “fantastic,” said Scott Schoettes, H.I.V. project director for Lambda Legal, an L.G.B.T. advocacy group.

“today we need the rest of the insurance industry to fall in line in addition to realize that will if they don’t, they will face legal actions against them,” Mr. Schoettes added.