“How can a safe, life-saving procedure that is prescribed by your doctor be denied by insurance companies? We know damage is being done to patients and families who wait for necessary proton therapy treatment and I am prepared to advocate for patients to receive treatment when ordered by their medical team!”
After my breast cancer came out of remission in April 2017, my doctors recommended getting a second opinion because surgery, chemotherapy, and traditional radiation treatments were found to be ineffective. In search of options, my husband, Rick, made an appointment to see if I would be a good candidate for proton therapy and we met with a team of doctors who highly recommended proton therapy to attack the aggressive cancer in a safe and beneficial way. Though I had never heard or been offered proton therapy before, this gave me such hope and the understanding that I would thrive with this treatment!
My renewed sense of hope was short-lived when my insurance company refused to pay for the treatment. I was shocked that my insurance company continued to deny the only form of treatment I had left. Making phone call after phone call for weeks to fight the denial, I felt the “game” begin. I lived in despair and defeat, getting either conflicting, incorrect answers or no answers at all. I remember my husband coming home from work one night and, through tears I said, “They won, I quit.” By that point, I had become emotionally worn down and could not function.
One day in August 2017, I was sitting at home with a mastectomy and no treatment when a life-long friend reached out to me and offered his help. He is an attorney and was just beside himself when we discussed the situation. He was able to reach my insurance company’s top lawyer and, within days, the CEO and top executives of the insurance company were apologizing and asking what I wanted. I started proton therapy September 2017.
I would not have had this outcome if it was not for the intervention of a special life-long friend who is a well-respected attorney. After receiving an immediate response from the insurance company, it became even more evident that insurance companies purposely put unnecessary roadblocks in the way of their clients to deny treatment in order to save money.
As I write this, my emotions are still so strong. I am heartbroken that this has happened for years to others––and that it is still happening. How can a safe, life-saving procedure that is prescribed by your doctor be denied by insurance companies? We know damage is being done to patients and families who wait for necessary proton therapy treatment and I am prepared to advocate for patients to receive treatment when ordered by their medical team!