BELOW SUPERNAV drop zone ⇩

Does insurance cover Ozempic, Wegovy? A lawsuit pushes for it

  • Washington nurse sues over obesity discrimination in health insurance
  • Weight loss drugs not consistently covered leave patients with high costs
  • Lawsuit claims exclusion is discrimination, highlighting medical necessity

MAIN AREA TOP drop zone ⇩

MAIN AREA TOP drop zone ⇩

ovp test

mLife Diagnostics LLC: Oral Fluid Drug Testing

Male shot by female at Shreveport apartment

Class to create biodiverse backyard

Rules for outbursts at Caddo School Board Meeting

AUTO TEST CUSTOM HTML 20241114185800

AUTO TEST CUSTOM HTML 20241115200405

AUTO TEST CUSTOM HTML 20241118165728

AUTO TEST CUSTOM HTML 20241118184948

(NewsNation) — A Washington state nurse filed a class-action lawsuit claiming the state agency responsible for procuring health insurance for public employees discriminates against those struggling with obesity by neglecting to include weight loss drugs in its coverage. 

Insurance companies are not consistently covering these drugs like Ozempic, Wegovy and Mounjaro when they’re prescribed for obesity. Many patients are left grappling with the daunting costs, often surpassing $1,000 monthly

Jeannette Simonton, the plaintiff who initiated the lawsuit, has explored numerous avenues to address her weight.

She lost 80 pounds through the use of the drug Wegovy. The weight loss has dramatically improved her quality of life, enabling her to engage in previously challenging activities. 

However, her insurance does not cover the medication. 

“It has been so disappointing. Because I feel like they’re looking at me like I’m in a box. I’m a check on a statistic in a box,” Simonton said. 

Simonton’s doctor, Peter Billing, said weight loss drugs like Ozempic and Wegovy are essential for treating obesity, a medical condition with well-established biological markers. 

“It’s just discriminatory against people who are obese, and it’s totally wrong. It’s a medical disease that’s due to elevated insulin secretion. We show it in the labs that we draw,” Billing said. 

Simonton and her attorney, Ele Hamburger, allege that insurers are discriminating against those who are obese.

After the Affordable Care Act and with similar state laws, health insurance companies are no longer legally permitted to discriminate based on disability or serious health conditions. 

The focus should be on the medical effectiveness of the treatment, and given the scientific consensus backing the efficacy of these weight loss medications, the exclusion appears to be a form of discrimination, according to Hamburger. 

Billing said that there is a misconception these treatments are merely cosmetic rather than medical. 

“The thought is people are obese because they’re lazy. They don’t cut down on what they’re eating, and they don’t exercise. This couldn’t be further from the truth,” Billing said. 

Being overweight or obese can have a serious impact on health. Carrying extra fat leads to serious health consequences such as cardiovascular disease (mainly heart disease and stroke), Type 2 diabetes, musculoskeletal disorders like osteoarthritis and some cancers (endometrial, breast and colon), according to the World Health Organization

While diet and exercise are effective for some, severe obesity necessitates a more robust intervention, according to Billing. 

Washington state law designates obesity as a protected disability, although this safeguard is not universal across all states. 

“The science here is so clear-cut that the only reason for continuing to exclude this kind of treatment is discrimination. It’s discrimination on the basis of disability,” Hamburger said. 

In a nation with over 100 million clinically obese individuals, a pressing question emerges: Should health insurance providers foot the bill for weight loss medications? 

Health

Copyright 2024 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed

 

MAIN AREA MIDDLE drop zone ⇩

Trending on NewsNation

AUTO TEST CUSTOM HTML 20241119133138

MAIN AREA BOTTOM drop zone ⇩

tt

KC Chiefs parade shooting: 1 dead, 21 shot including 9 kids | Morning in America

Witness of Chiefs parade shooting describes suspect | Banfield

Kansas City Chiefs parade shooting: Mom of 2 dead, over 20 shot | Banfield

WWE star Ashley Massaro 'threatened' by board to keep quiet about alleged rape: Friend | Banfield

Friend of WWE star: Ashley Massaro 'spent hours' sobbing after alleged rape | Banfield

Mostly Cloudy

la

57°F Mostly Cloudy Feels like 57°
Wind
3 mph SW
Humidity
94%
Sunrise
Sunset

Tonight

Cloudy. Low around 50F. Winds light and variable.
50°F Cloudy. Low around 50F. Winds light and variable.
Wind
4 mph N
Precip
8%
Sunset
Moon Phase
Waning Crescent