di-for-doctorsSome health care practitioners are being denied insurance coverage, and it appears to be a side effect of the opioid epidemic. The problem isn’t that these applicants are addicts. It’s that they carry naloxone, a prescription medicine used to reverse overdoses.

The opioid epidemic is claiming lives.

According to the CDC, 115 Americans die from opioid overdoses every day. Between 1999 and 2016, the number of opioid overdose deaths increased five times. Deaths are caused by illegal opioids like heroin as well as prescription opioids.

Fentanyl, an exceptionally strong prescription opioid, is often produced illegally, and it is closely associated with many cases of addiction and overdose.

Naloxone can save lives.

Naloxone is a prescription medicine that can reverse an opioid overdose by blocking opioid receptor sites. The medicine must be administered by a family member, friend, emergency responder or bystander, as the person experiencing the overdose won’t be able to self-administer.

Having naloxone on hand is important in case an overdose occurs. According to CVS, 48 states give pharmacists prescriptive authority to dispense naloxone. This means that anyone can get naloxone at a pharmacy without obtaining a prescription from a doctor.    

The Surgeon General issued an Advisory on Naloxone and Opioid Overdose, encouraging people to carry naloxone. The message was clear: “BE PREPARED. GET NALOXONE. SAVE A LIFE.”

People have responded to the Surgeon General’s call – and then been denied insurance.

In response to the Surgeon General’s advisory, as well as general awareness of the problem, many health practitioners have gotten a prescription of naloxone to carry with them, in case they witness of overdose and need to administer it.  

Unfortunately, insurers may see the prescription history and assume the prescription means the applicant is at risk of an overdose.

NPR reports that this is exactly what happened to a nurse who was denied by two separate life insurance companies. Her experience isn’t unique, either. A doctor in the report says he knows of half a dozen people who have encountered problems getting life or disability insurance because of their decision to carry the life-saving drug.

Be ready to help your clients.

This is still an emerging problem, and hopefully a good solution will be worked out soon. In the meantime, be ready to help your clients.

  • Some insurers may ask for an explanation or be willing to reverse a rejection if additional information is provided. Advise your clients that they may need a letter explaining the purpose of the naloxone prescription.
  • If an insurer still won’t approve coverage, look for another insurer with more understanding policies regarding this issue.
  • Keep in mind that the issue affects many people, not just health care practitioners. Your clients may carry naloxone if they have a friend or family member who struggles with opioids, or if they work with at-risk individuals.

If you have any concerns about your DI applicant, contact the sales team at DIS and we’ll interface with the carrier and help you navigate the underwriting process.


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