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Anything on your medical record can impact a life insurance policy, but there is a way to get a naltrexone prescription without losing coverage.
The Short Answer
Taking naltrexone does not automatically prevent you from getting life insurance. However, life insurers may consider your prescription history, medical records, alcohol use history and the condition for which a medication was prescribed when evaluating an application.
Paying for naltrexone without health insurance may mean there is no health-insurance claim for the medication, but it does not guarantee that the prescription or related medical information will be absent from records available during underwriting.
If life insurance is a concern, the most important thing is to answer application questions accurately and understand what information the insurer may review.
What You’ll Learn:
• How life insurance providers know if you have a naltrexone prescription through health insurance.
• Physician statements
• Medical Information Bureau documentation
• Why life insurance companies scrutinize all prescriptions, including naltrexone.
• What you can do to have the medication you need and the life insurance you want.
• Use FSA and HSA funds for your naltrexone prescription.
• Opt for an extended plan to lower the cost.
Some people have found that getting a naltrexone prescription through their health insurance can create problems when it’s time to get life insurance. But don’t worry. There’s an option that helps avoid life insurance issues so that you don’t have to choose between a medication that can improve your health and getting coverage.
How Using Health Insurance to Pay For Naltrexone Gets Flagged by Life Insurance Providers
You may be able to get part of the cost covered by insurance, but it’s not always as cost effective as you might think. We’ve already gone over some of the hidden costs of using insurance to pay for naltrexone. However, there are some indirect costs worth noting as well. Not being able to get life insurance is one of them.
If you pay for naltrexone using health insurance there are several ways that life insurance providers can find out.
Prescription Databases
When you use your health insurance to pay for any prescription it gets reported to prescription databases like Milliman IntelliScript and Omnicell. The databases pull the information from insurance claims and pharmacy benefit manager records. The insurance providers then pull the information from the database to make decisions about policies.
Physician Statements
If you discuss any prescription medication with a doctor it may end up in their physician statements. If they end up billing your health insurance company for their services the statements can become part of your medical record that’s now centralized and electronic. Most life insurance providers request your medical records when you apply for a policy.
Medical Information Bureau Documentation
The MIB tracks the coded data on insurance records. Codes can lead back to medical care and diagnoses that are a red flag to life insurers that look over the documentation.
Why Life Insurance Companies May Have Issues
When you think about it, life insurance companies should see naltrexone as a positive. It’s a sign that someone is investing in their health and making healthy lifestyle choices. It’s the same as someone who smokes using a patch to cut back or quit cigarettes.
But the truth is, life insurance companies scrutinize everything they can find in a medical record. And they are going to dig through all the records they can find.
The goal is to get a clear idea of how healthy a person is and whether they make any risky lifestyle choices. Because naltrexone is FDA-approved to treat alcohol use disorder and opioid addiction, some insurers consider it a red flag for potential health issues and risky behavior that increases the chance of serious injury or death.
For a life insurance company it’s all about risk assessment. They always err on the side of caution and could outright deny applications for life insurance if they see that an applicant takes naltrexone or any other prescription medication.
For the many sober curious people who take naltrexone to simply cut back on drinking in an actionable way, this can be a concern. They aren’t battling an addiction. They’re taking the initiative to improve their health by establishing healthier habits.
Fortunately, you have options for getting a naltrexone prescription that preserves your privacy and life insurance benefits.
How to Get Naltrexone For Less Without Impacting Life Insurance
There are pros and cons to using health insurance to pay for naltrexone medication. For some people the tradeoffs aren’t worth saving 50% or so on a fairly affordable prescription. Those people are the ones who gravitate to online prescription platforms.
Getting naltrexone online through a reputable telehealth platform like Choose Your Horizon allows you to pay directly for the medication. Going that route the prescription isn’t typically reported to the public databases that are checked by insurance providers.
Online alcohol treatment programs without insurance are actually more cost effective than many people realize, and with us you aren’t sacrificing the ability to work directly with a qualified clinician. There are a few additional ways to ensure the medication you need is budget-friendly.
Pay With an HSA or FSA Account
Choose Your Horizon is one of the telehealth providers that accepts HSA and FSA payments for naltrexone. A Health Savings Account or Flexible Spending Account allows you to use pre-tax dollars to pay for healthcare needs. It effectively lowers your taxable income by putting money into an HSA or FSA to cover the cost of naltrexone.
Go With a Longer Plan
Some providers only offer one option for a naltrexone treatment program at a set monthly or annual cost. Others offer more flexibility on naltrexone pricing with tiers based on the length of the plan. Usually if you opt for a 6 or 12 month plan it will cost less than a single month or quarterly plan.
Getting Naltrexone Without Health Insurance Can Be Affordable and Confidential
When you consider all of the costs that are involved, paying for naltrexone through insurance isn’t much cheaper than paying out of pocket, and it can come with other limitations. Plus, when you go with Choose Your Horizon you get a lot more than medication. We provide evaluations and check-ups with qualified clinicians, an app with valuable resources and a community that provides additional support.
If you’d like to learn more about getting a naltrexone prescription online take the Alcohol Use Assessment. It’s free, only takes a few minutes and provides feedback on whether alcohol medication could be beneficial.
