Health Insurance Denials

I've heard so many stories about how health insurance would deny many in the lung cancer community. It was horrible to hear about this because being diagnosed with lung cancer was not on our agenda.

I just never understood why certain health insurance would deny someone the care and treatments they need. We spend years working and paying for our health insurance just to turn around and deny someone, which is simply unbelievable.

My health insurance denied life-saving treatment

I must say I've been very fortunate to not have to deal with my health insurance denying my care often. But it did happen to me, thankfully, only once.

When I was first diagnosed, I went to a cancer center facility for my treatments, but I remember the cancer facility had to get approval from my health insurance to start chemo and radiation. That was approved, and treatment started in December of 2014.

When I finished my treatments, I went to the Mayo Clinic for a second opinion, and my insurance also covered that. I was told of an amazing molecular doctor at the University of Chicago Medical Center there.

I made the appointment, and it was covered by my health insurance. When I found out I was ALK-positive, I was told I could start on targeted therapy, and I was prescribed Xalori (Crizotinib), and that is when the nightmare began.

When it was prescribed and sent to my husband's health insurance, it was denied immediately. I couldn't remember why it's been that long, but it was denied.

I remember being devastated and not understanding why. My husband was so upset that he took it to Facebook and vented about our health insurance and the insurance industry. We knew if we didn't appeal it and fight, I literally would have a few months to maybe two years.

The battle for approval

Our fight began against my husband's health insurance. But before that, a friend of my husband saw his Facebook post and reached out to my husband. He told my husband, "I have $10,000. I'll gift it to you so you can at least get a 30-day supply for your wife's treatment."

I'll never forget that kind gesture from my husband's friend. I always say there are still good people on this earth!

When the health insurance denied my prescription, I notified my oncologist and team at the University of Chicago Medical Center. They joined me in the fight and contacted the health insurance and fought on my behave.

Then, the gentleman who worked for the health insurance that was helping me from day one also got involved on his end and spoke against the denial. The HR department at my husband's job also got involved, called the health insurance, and fought for me to get it approved.

The power of persistence

Our fight wasn't over. My PCP also got involved and had her office people call my husband's insurance and fight for me as well. To say the least, I had many people calling my husband's insurance company and fighting for me to get my targeted therapy approved, and it worked!

I think after the insurance company got so many calls, emails, and probably letters that were faxed, they gave in and approved my targeted therapy. I began taking it in March of 2015.

This was my only negative experience with health insurance, but it was enough. It was a very stressful time for me, and it filled me with uncertainty, but we didn't give up.

So, if you find yourself in a similar situation or even a worse one, please don't give up. You fight and keep fighting because we all deserve to be able to treat our illness and get your care team involved, too.

They can really make a difference in health insurance decision-making.