Elevance Faces Lawsuit Over Sleep Apnea Drug Coverage

A woman with obstructive sleep apnea accuses the insurer of failing to cover the weight-loss drug Zepbound.

Apr. 10, 2026 at 1:51pm

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A translucent X-ray photograph revealing the internal structures of the human respiratory system, with the lungs and airways highlighted in glowing, ghostly lines against a dark background, conceptually illustrating the medical issues at the center of this insurance coverage dispute.An X-ray view of the human respiratory system highlights the challenges of treating obstructive sleep apnea, a condition at the heart of this insurance coverage lawsuit.Indianapolis Today

A federal judge has allowed the bulk of a proposed class action lawsuit to proceed against Elevance Health Inc. and Anthem Health Plans of Kentucky Inc. The lawsuit, filed by Amy Newkirk, accuses the insurers of wrongly denying coverage for the weight-loss drug Zepbound to treat her obstructive sleep apnea.

Why it matters

The case highlights ongoing disputes between patients and insurers over coverage for medications used to treat conditions like sleep apnea, which can have serious health consequences if left untreated. The outcome could set a precedent for how insurers must approach coverage decisions for similar weight-loss drugs.

The details

Judge Matthew P. Brookman of the U.S. District Court for the Southern District of Indiana ruled that Newkirk can proceed with claims for wrongly denied benefits and fiduciary breach under the Employee Retirement Income Security Act (ERISA). However, the judge blocked Newkirk from seeking disgorgement or restitution under ERISA because she did not identify specific funds in the defendants' possession that she is seeking through the lawsuit.

  • The lawsuit was filed in 2026.

The players

Elevance Health Inc.

A major health insurance company that was formerly known as Anthem Inc.

Anthem Health Plans of Kentucky Inc.

A subsidiary of Elevance Health that provides insurance coverage in Kentucky.

Amy Newkirk

The plaintiff in the proposed class action lawsuit, who has obstructive sleep apnea and was denied coverage for the weight-loss drug Zepbound.

Judge Matthew P. Brookman

The U.S. District Court judge presiding over the case in the Southern District of Indiana.

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What’s next

The case will now proceed to the discovery phase, where both sides will gather evidence and prepare for a potential trial.

The takeaway

This lawsuit underscores the need for greater transparency and consistency in how insurers make coverage decisions, especially for treatments that can significantly impact patients' health and quality of life.