A cancer patient from Arizona is denied coverage by his insurance carrier.
A man in Arizona who is undergoing treatment for cancer claims that his insurance carrier has refused to cover an essential component of his treatment.
“Our insurance is throwing a curve ball at us like this and I’ve got days to solve it. It’s unacceptable,” said Gary Schmit, who says he’s running out time to get the radiation therapy he needs to fight his throat cancer.
According to his wife, Serena, his insurance company, Anthem Blue Cross Blue Shield, is refusing to pay out whatever they have filed.
“They deny it as if they know more than our doctors at the Mayo Clinic know about what is best to treat his cancer,” Serena said in response.
According to Schmit, the first step in his treatment plan would be to have surgery to remove his tumors. However, Anthem did not give their approval for the radiation that will follow that treatment.
“It doesn’t make sense that they’re almost à la carte my treatment. It’s cancer treatment,” Schmit remarked.
He emphasizes that the radiation treatment is only effective if it is administered five to six weeks after the surgery. That occurred a month ago, and Schmit claims that everything was delayed even before the denial was made. This was due to an unusual issue.
“I didn’t know if he was going to make it. It was scary, scary. And so it’s just it’s been a lot to go through. gets emotional,” Serena said.
According to Schmit, he is making progress and the tumors have disappeared. It is time for him to move on to the next level, according to his medical staff.
“It’s not like somebody wants to get radiation, you know?” Serena chimed in.
“If I don’t have the radiation treatment, there’s a 20% more chance that the cancer returns. So they’re messing with 20% more of of my life at that point,” Schmit declared.
In a statement, Anthem asserts that the radiation that is being requested is not required for the treatment of this type of cancer. Schmit, on the other hand, claims that his physicians are of the opposite opinion, and that the therapy might cost about $250,000 out of pocket.
“Something seriously wrong with our health care system if the health insurance companies are dictating what kind of treatment we’re receiving over the specialists, the experts,” Schmit said during his presentation.
One another obstacle to overcome in the midst of a challenging prediction.
“All that turmoil, you have to deal with the cancer, but then also the rage that you feel at just being a number on the back end and it’s like this is like this is somebody’s life,” Serena said to the conversation.
The following is an excerpt from a statement that was sent by Anthem Blue Cross Blue Shield: “The requested service was denied due to the particular type of radiation requested not being medically necessary to treat this form of cancer. Anthem continues to work with this member to ensure he receives clinically appropriate and medically necessary care.”
