The Case That Sparked Awareness
In 2018, a Boston nurse—referred to as Isela—was
denied life insurance because her medication list included naloxone—a drug she
carried to help others survive opioid overdoses. Insurers apparently
interpreted this as a sign of personal drug use, raising concerns about risk KFF Health
NewsWBUR.
Even though naloxone is vital in the opioid crisis response,
Isela’s applications were canceled. One company required a doctor's note
confirming the naloxone was carried for altruistic use only KFF Health
Newsadvisory.com.
Regulatory Pushback & Reforms
New York
After similar reports, Governor Andrew Cuomo directed the NY
Department of Financial Services to investigate. The resulting guidance warned
that denying coverage solely based on naloxone prescriptions is unfair discrimination under state law WKBW 7 News
BuffaloLewis & Ellis.
Massachusetts
Similar action followed in Massachusetts. The insurance regulator
issued guidance advising insurers to distinguish between naloxone prescribed
for personal use versus “Good Samaritan” purposes Lewis &
EllisWBUR.
Where Things Stand in 2025
Underwriter Attitudes: Mixed, but Improving
According to RiskQuoter (February 2025), some insurers still flag
naloxone use—but others will approve coverage if circumstances are clearly
explained:
|
Insurer |
Likely Approach if Carrying Naloxone |
|
AIG
/ American General |
May
accept at best rate if no substance abuse history |
|
AXA |
Case-by-case
underwriting |
|
John
Hancock |
Evaluated
on individual merits |
|
Lincoln
Financial |
Can
qualify for best class if healthy |
|
Pacific
Life |
Underwrites
healthcare workers positively |
|
Protective |
No
rating if no personal misuse |
|
Transamerica |
Accepts
with explanation |
|
Others
(e.g., Nationwide, United of Omaha) |
Likely
decline RiskQuoter.com |
What Healthcare Workers Can Do Now
1. Be Transparent and Proactive
If you carry naloxone, disclose it up front in applications.
Include a cover letter or your doctor's note explaining your role as a
caregiver or first responder—not a person with opioid use.
2. Choose Your Insurer Carefully
As noted above, some insurers are more accommodating than others.
Work with an independent agent who understands high-risk underwriting trends.
3. Know Your Rights in Your State
States like New York and Massachusetts now mandate fair treatment
for naloxone carriers. Check whether your state has similar protections—these
can be vital leverage if denied.
4. File Consumer Complaints if Denied
In states with regulatory guidance around naloxone, you can file
complaints with your department of insurance. This can bring attention and
prompt a review.
5. Have a Documentation Strategy
Keep letters from doctors or public health authorities confirming
your naloxone is for good-faith rescue use. This can help underwriters see
beyond the prescription flag.
6. Follow Legislative Trends
New cases and regulatory updates may continue emerging, especially
amid evolving public health norms. Stay informed or work with a knowledgeable
broker.
Summary Table
|
Need / Concern |
Recommended Action |
|
Carrying
naloxone affects coverage |
Disclose
it proactively with an explanation |
|
Being
denied due to naloxone |
File
complaint if state protections exist |
|
Insurance
options |
Choose
insurers known for flexible underwriting (see table above) |
|
Future
flexibility |
Stay
informed and keep documentation ready |
Final Thoughts
Carrying naloxone is a public service—not a personal risk. While
early cases highlighted a serious oversight in underwriting, regulatory reforms
in several states have begun to catch up. In 2025, healthcare workers should
still exercise caution—but also advocacy:
·
Explain your use proactively.
·
Choose accommodating insurers.
·
Leverage state protections.
·
Maintain proper documentation.
Advocating for fair treatment not only protects your coverage—but
ensures lifesaving behaviors don’t become hidden risks.
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