A Falmouth woman has filed a class action lawsuit against her health insurance company, alleging that the company unlawfully discriminated against her by refusing to cover a weight-loss drug because of her disability (obesity).
[RELATED: 30% of Maine High School Students Overweight or Obeseā¦]
“This type of discrimination is not new, but rather stems from a long history of prejudice, exclusion and stigma against people with disabilities in general and those diagnosed with obesity in particular,” Jamie Whitmore, 29, said in her complaint.
“Defendant Cigna Health Life Insurance Company (“Cigna”) discriminates on the basis of disability by designing and/or administering health plans that do not cover any prescription drugs to treat a medical condition that is also a disability, obesity,” she added.
The class action lawsuit is based on the premise that obesity is a disorder that, although it can be treated with exercise and diet, must in fact be treated with medication.
Whitmore, who works in Maine’s public university system, was prescribed Ozempic in February 2023 and initially had it covered by his insurance.
But she was informed in August that her insurance company would not pay for Ozempic, even though she claimed it was “medically necessary” to treat her “disability.”
She was also denied insurance coverage for Zepbound, another weight-loss drug.
Whitmore claims she cannot afford the medication without insurance help.
As part of the terms of Cigna’s health insurance contract with Whitmore, the company does not cover drugs intended to treat obesity.
Her lawyer, Jeffrey Young, argues that the company is still required by law to cover the cost of her medication and that failing to do so constitutes disability-based discrimination.
Young argued that Whitmore’s class action lawsuit is the first of its kind in the nation.
Although obesity is not specifically listed as a disability under the Americans with Disabilities Act (ADA), courts have determined that in certain cases, such as when someone has an underlying medical problem that makes it impossible to lose weight through exercise or diet, obesity can be considered a disability.
It’s unclear from the lawsuit and other reports whether she had any underlying medical conditions that contributed to her obesity.
