United Healthcare has issued an official apology for denying PrEP coverage to a bisexual customer because he engaged in “high risk homosexual behavior.”
In a letter dated July 11, 2017, United Healthcare denied pre-authorization for Truvada coverage for New York resident Thomas Ciganko, who had been prescribed PrEP by his doctor.
“The request for coverage for Truvada is denied,” the letter read. “The information sent in shows you are using this medicine for high risk homosexual behavior.”
The letter then cited one of the applications for PrEP use as “to reduce the risk of sexually acquired HIV-1 infection in adults at high risk,” but went on to state, contradictorily, “You do not meet any of these criteria.”
The letter was posted in an HIV-prevention Facebook group by Act Up New York activist James Krellenstein last week.
Following an appeal, Ciganko’s PrEP coverage was ultimately approved by United Healthcare. But many people found the wording of the letter deeply troubling, and some pointed out that this kind of bureaucratic red tape, along with the exorbitant cost of Truvada, serve as major barriers to access.
The CDC indicates that around 1.2 million gay and bisexual men, or about one in four, would benefit from taking PrEP—an estimate far greater than the number of people currently taking the drug.
Following outcry by activists and the launch of a petition that garnered nearly 3,000 signatures, United Healthcare has issued a formal apology.
“We apologize for the insensitive language appearing in the letter and regret any difficulty it caused,” the insurance giant, which is one of the largest providers in the country, said in a statement. They also announced that they had updated their policy on Truvada to stop requiring pre-authorization for the drug, effective immediately.
“We have corrected our letters,” the statement reads, “removed the prior authorization requirement for Truvada and members can fill their prescription at the network pharmacy of their choice.”
In response to the apology, Krellenstein said, “Activism works. After only five days of pretty intense pressure from AIDS activists, we got one of the largest health insurers in the nation—United Healthcare—to completely cave.”
Damon L. Jacobs, creator of the PrEP Facts Facebook group, told NewNowNext, “I hope this serves as a cautionary tale for other insurers. If you create unnecessary barriers to PrEP access, we’re gonna fight back.”
“I think this was a beautiful reminder that in these political times, we can achieve so much when we all work together from our different corners of the world,” he added.
Ciganko, who received the initial letter, told NBC News that he’s “pleased [United HealthCare] is doing the right thing,” saying, “I’m very happy if releasing this letter has played any part in bringing forward positive change. I’d do it in a heartbeat again.”