A Maine woman has filed a lawsuit against the parent company of Anthem insurance for denying claims to cover weight loss medications to treat obesity.

It’s the second lawsuit filed in Maine this year against insurance companies for denying claims for weight loss drugs. The first one, filed in June against Cigna, was one of the first of its kind in the nation. A similar lawsuit was filed in Washington state in late 2023, according to news reports.

The most recent Maine lawsuit was filed against Elevance Health in U.S. District Court in Portland on Sept. 20 by Rebecca Holland. Elevance is the parent company of Anthem, Maine’s largest insurance carrier.

The lawsuit says that Anthem’s “obesity exclusion” clause prevents patients like Holland from accessing drugs like Ozempic, Wegovy and Zepbound because Anthem won’t cover them for weight loss.

The drugs work by suppressing a person’s appetite.

Zepbound and Ozempic belong to a group of drugs that have been prescribed to treat diabetes and are now hugely popular weight loss medications prescribed to treat obesity.

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Zepbound, for example, is a weekly injection that can cost more than $1,000 a month for patients who pay out of pocket. It is generally covered for use in managing diabetes, but many insurance plans do not cover it for weight loss.

Insurance coverage of the increasingly popular weight loss drugs and the rapidly rising costs have been a concern in the insurance industry and among employers, which determine what coverage to include in the plans offered to their workers.

The new Maine lawsuit says that Anthem’s plan will not cover the drugs for patients even if it’s deemed “medically necessary.” And it argues that limiting treatment for obesity ends up costing more in the long run because of related health risks.

According to the lawsuit, the “obesity exclusion is irrational, arbitrary and likely more expensive than covering prescription medications for obesity. Indeed, the longer Anthem continues to design and administer the obesity exclusion, the more it puts the health and lives of its enrollees diagnosed with obesity at risk for the many symptoms and co-occurring conditions associated with obesity.”

Holland, the lawsuit says, is enrolled in an Anthem plan through her employer, Falmouth schools, and “was subjected to disability discrimination by Anthem because she is diagnosed with obesity, a (disabling) health condition, and she requires treatment with medically necessary prescription medications for that health condition.”

Obesity exclusions in insurance policies violate the Affordable Care Act, which protects people with disabilities, including those with obesity, according to the lawsuit.

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“This type of discrimination is not new; rather, it follows from a long history of prejudice, exclusion, and stigmatization of people with disabilities in general and of people diagnosed with obesity, in particular,” according to the lawsuit.

Shelby Leighton, Holland’s Washington-based attorney, declined a request by the Press Herald for an interview with Holland. Stephanie DuBois, an Anthem spokeswoman, also turned down an interview request, saying that Anthem does not comment on pending lawsuits.

Holland has experienced “sleep apnea, numerous foot, shoulder and other musculoskeletal injuries requiring physical therapy and that have limited her ability to walk and stand for periods of time, has had high cholesterol, all as a result of her condition of obesity,” according to the lawsuit.

She has at times paid out of pocket for the medications. While the lawsuit didn’t state how much Holland was paying paid out of pocket, these weight loss medications without insurance can cost $1,000 per month or more.

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