An Unexpected Reason for Coverage Denial

You probably know that you can be denied life insurance for certain health conditions, but did you know you can be denied based on medications you purchase on behalf of someone else?

This is what happened to a Boston woman. Employed as a nurse, she had a prescription for the opioid-reversal drug naloxone, also known as Narcan, which she used in her job at an addiction treatment program. (It’s also become common for family and friends of those with an addiction to carry a prescription for naloxone.) This prescription resulted in the nurse’s insurance denial.

Why would it matter if she carried this prescription?

When reviewing applications, some life insurance companies consider prescription drug use. During this process, it can be difficult to determine the difference between someone who carries naloxone for themselves (because they are at risk of an overdose) or others (because they are caring for someone with an addiction).

Could you be penalized for your prescriptions? Yes, even if you don’t carry any drugs for others as this nurse did. Life insurers consider all aspects of your medical history (including doctor’s visits, diagnoses, and medications) when analyzing your risk. They can deny coverage if they deem the risk is too high.

What can you do if you’re denied coverage? Ask for an appeal. The method for doing so should be explained in your application materials.

Generally, the process involves three steps to create your appeal.

  1. Read your denial letter to understand the details and understand why the insurer denied your application. If the reason for the insurance denial wasn’t provided, you can request it in writing, as you have a legal right to receive it.
  2. Gather evidence to support your appeal, such as doctor’s notes.
  3. Write a compelling appeal.

If you need help with this process, your insurance agent can assist you with further details and support.

An Unexpected Reason for Coverage Denial
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