You may be denied life insurance for carrying naloxone (2018) | Hacker News Reader

You may be denied life insurance for carrying naloxone (2018)

wbur.org

So if the leading cause of death from the 18-45 year old group is opioid overdoses

and since abstinence only education is ineffective

and the culture could be updated to carrying naloxone to prevent said deaths, if people were actually willing to have a conversation that wasn't based on abstinence only

then.... this is a dumb and counterproductive policy? how much of the insurance pool is really affected? ... the narcan is to save your friends if you're there, this is like saying "there's a defibrillator nearby so since you might die, insurance denied" with a difference being that there was a purchase record. if an insurance pool is part of the calculation, would that difference matter? seems like you would need actual evidence instead of guesswork.

Insurance only makes sense in the context of making money for insurance companies. Putting these behaviors into the context of saving and improving lives is absurd. The incentives of American healthcare are endangering our lives. "Your money and your life!"

Right, but since they have to pay out sometimes or the ponzi[0] stops as people stop contributing, then this could only rely on the public lack of empathy towards "drug users"

[0] replace "ponzi" with "scheme", "mechanism", or any word you coincidentally apply to financial concepts you happen to respect

This is about life insurance not health insurance, health insurance cannot deny you.

I skimmed it and I'm a little confused by a detail.

> She contacted her insurance agent and was told her application was denied because something on her medication list indicated that Isela uses drugs. Isela, who works in an addiction treatment program at Boston Medical Center (BMC), scanned her med list. It showed a prescription for the opioid-reversal drug naloxone, brand name Narcan.

> Isela had bought naloxone over the counter at a pharmacy, as can anyone in Massachusetts.

If Isela bought the narcan OTC and her PCP didn't know about it (aka it wasn't in the medical records), how did the insurance company find out about it?

She listed a drug she (allegedly) doesn’t take in the application field meant for drugs she does take, and it confused the system.

(Edit - may not have been her fault, strictly. Sounds like the system needs a “taking” vs “for others” flag, but that also sounds ripe for abuse… I’m sympathetic to insurance companies erring on the side of “you have it, you might be taking it”)

The second half of the article explains that she had a "prescription" for it from a doctor she didn't actually know (this drug is only sort of OTC, apparently), and the technicality alerted the computer.

The insurance companies then confirmed that their flagging / rejecting of applications like hers is intentional.

In her case, it may have also been run through medical insurance to cover the cost.

There are a few ways this could end up in the hands of a life insurance company, no erroneous form-filing needed.

This happened to me with a prescription drug for seizure medication for my dog. The prescription was written to me and dispensed to me so it showed up in my medical records that I had released to the insurance company. It was fairly easy to clear up though because it was written by a veterinarian and the "patient" name was ellie $dogName kelly. (Thankfully my dog's name is different from my middle name!) Technically the prescription was indeed "mine" it just wasn't ever intended for me to take.

Credit card data.

Since when do point-of-sale terminals send itemized receipts to your bank when using a credit card?

Google "Credit Card Level 3 data"

https://paymentdepot.com/blog/level-3-data-processing/

Holy shit, fuck all of that. I don't want that info being sent to my bank or collected at all.

Have you ever looked at your CC statement?? It lists every transaction - so apparently this was bought by her prospective insurance company - which is evil.

My CC statement shows each transaction, how much it was, and where it took place. But I've never seen it include any information about what was actually purchased.

So my question is, how could an insurance company know what prescriptions you picked up at Costco last week based only on data from your bank?

I'm pretty sure your pharmacy cannot even share that data with your bank without violating HIPAA.

I really appreciate the cynicism here, since most people have no idea how much detailed customer information retailers and banks are gathering and selling, but I think in this particular case it is misplaced.

In this case it's likely mostly paranoia - but level 3 card data I assume by now is every single major retailer in the US. This would include CVS and Walgreens, as well as Target, Walmart, etc. In that case an insurer could trivially get this data simply by a common data subscription available on the market. Not sure if HIPPA would cover retail (OTC) sales at all, I'd guess not?

In any case, I consider pretty much any credit card transaction I do with a major company as 100% public information down to the SKU and qty purchased.

More likely here though is that this is a controlled substance treated like Pseudoephedrine is. There your ID must be scanned, and it is enrolled in a national database. This is a federal statute and I would be stunned if insurance didn't mine this information.

Loyalty cards, Bluetooth/Wifi sniffers, facial recognition and license plate cameras all gather identity / pseudonymity data. Backend servers correlate those sensors with PoS terminal data and sell the result to all sorts of unsavory companies / governments.

This is a big industry. California's "Do Not Sell My Personal Information" law even has specific carve outs for retail consumer surveillance firms.

Companies have been tapping into transaction data to sell us more things as early as the 1990s, when credit card giants such as American Express analyzed purchases to tailor special offers to cardholders. Marketers with more limited vantage points, meanwhile, pooled the data from their own cash registers to get a better view of their customers.[0]

[0] https://www.fastcompany.com/90490923/credit-card-companies-a...

Was it covered by her prescription drug insurance?

> If Isela bought the narcan OTC and her PCP didn't know about it (aka it wasn't in the medical records), how did the insurance company find out about it?

All pharmacy transactions, including many, many "OTC" sales, are heavily surveilled. I can't buy freakin' dramamine withouth showing ID, even though it's "OTC" here. It wouldn't be very surprising for an insurer to have access to that stuff.

Interesting. Is that specific to your state?

Here in WA, I've never shown my ID at a drugstore even for prescriptions much less OTC>

On the federal level pharmacies are required to log purchases for some drugs including those containing Pseudoephedrine, they are required to get ID for this. Same for controlled-substance prescriptions.

Because "over the counter" is a bit of a misnomer. You must go to a pharmacy and speak to the pharmacy rep or pharmacist, who has access to the standing order that creates a prescription that's automatically rubber-stamped by an issuing physician.

Now you've been "prescribed" Narcan, for all intents and purposes. The pharmacy now fills it via the normal procedures, including submitting to insurance as required to obtain payment for it behind the scenes.

So... your insurance knows now you have (at least) once "taken" Narcan.

Same thing happens when you go to a pharmacy for a flu or COVID shot or other vaccines: a remote physician "writes" the prescription for the vaccine, to which the pharmacist then draws and administers.

YSK: Naltrexone, an anologue to Naloxone, can reverse alcoholism and food addiction. The process you need is The Sinclair Method. Naltrexone and Naloxone are opioid-antgonist

  1. Take the naltrexone
  2. Wait an hour
  3. You know have about a 4-6 hour window you can drink.
  4. Redose with a half dose if you need to drink more.

I wanted to try moderation and got a prescription for Naltrexone - I ended up just quitting cold turkey and never looked back.

Threw away my Rx without taking a pill...and now I can't get life insurance.

Reckless to just shotgun unqualified medical advice into a comment section like this.

2 things come to mind, 1 - Employer based Group Life is often Guaranteed Issue upto a certain benefit. No questions asked. I write a ton of it.

2 - Did she quote any other carriers? Mass Mutual comes to mind... if not, sounds like the broker dropped the ball to me. Individual policies are tougher to underwrite.

What is this, someone reasonable who actually has relevant experience? Get out of here!

Is Group Life as a work benefit a common thing in the US? I polled my friend group and the only one who has it is a government employee. I've certainly never been offered it.

Yes, very popular and typically not expensive. Often we can go a step further and offer Voluntary Group Life in addition to employer paid Group Life. Executive Carve out for C Suites, I can go on and on...

More Typical Corporate Algorithmic Idiocy.

They assume that Naloxone prescription correlates with drug use which correlates with high death rates, therefor deny coverage. Yet this is literally a statewide prescription for EVERYONE AND ANYONE, but they ignore that fact, aaand collateral damage ensues.

Same as software and insurance companies assuming that high braking and cornering forces are automatically signs of bad driving when they are literally the hallmark of highly trained/skilled drivers (the difference is that the highly skilled drivers know where is the limit of adhesion and rarely exceed it while the ignorant teenager will often sail right past the limit of adhesion and slide into a tree or something).

Same as Google or Amazon deciding to ban all of a user's accounts for some reason that triggers some algorithm that maybe sometimes correctly identifies fraud or system abuse, but creates huge collateral damage when wrong.

It is pretty obvious that managers deploying technology either don't know or don't care about such consequences - they are externalizing their failures on the general population.

I don't know how to fix this sort of thing short of legally requiring companies to provide reasonable recourse and imposing costs if they don't (e.g., the damaged party can demand prompt & effective recourse and if they don't get it can easily sure and collect damages.)

I have a narcan prescription because of my oxycodone prescription. Interesting. It's short term so I should just wait before life insurance. It would be useful to have this stuff on a wiki somewhere.

It's standard practice in some hospitals to prescribe Narcan when prescribing large amounts of opiates...

This article is from December 14, 2018.

What's weird is... cocaine can kill you, no OD necessary. Alcohol will kill you. Smoking national brand cigarettes will definitely kill you. Opiates generally don't kill you. Notorious addict and writer William S. Burroughs lived to 83, and died of a heart attack. His death had nothing to do with using heroin for 60 years or however long.

What hurts opiate addicts is the lifestyle, not the drug. But if they have a job and a stable economy, there is no health effect. What kills opiate addicts is two things.

1) The user quits, then maybe after a year of being clean, to celebrate perhaps, they take their regular dose again, and their tolerance has dropped to nothing, and they accidentally overdose. I believe this is how Sublime's Bradley Nowell died, and possibly Tom Petty.

2) Evil, sociopathic dealers that spike their heroin with fentanyl, likely aware they will kill someone, because they think it is good advertising, letting everyone know their stuff is strong. I believe this is how we lost Philip Seymour Hoffman, and many many others.

So even beyond the obvious detail, that Naloxone saves lives, I don't understand what life insurance companies have against opiate addicts, and more so than smokers and drinkers? That makes no sense.

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