Largest insurance company US drops coverage...
Posted by Richard Bonine, Jr (+14993) 11 years ago
Fortunately, this story has a happy ending, but it took the involvement of her congressman to get the largest insurance company in the US to change it's mind.

Diana Smith has gone through six months of radiation and chemotherapy -- one week out of every month. She fears she will die without the bone marrow transplant scheduled for Tuesday.

Diana Smith is battling a rare form of Leukemia and needs the transplant to survive. She managed to raise money to pay for it thanks to her friends and the community, but then last week she found out her Medicaid coverage was dropped - putting her operation on hold.

Smith had gone through six months of radiation and chemotherapy -- one week out of every month. She is in remission and had a donor for a transplant; being in remission is a prerequisite for the transplant.

But her hopes of receiving the transplant were dashed in March, when she says, the Social Security Administration contacted her -without her soliciting it -- and told her that her three year-old son was entitled to receive Social Security disability payments. Even though she didn't ask for it, she signed the form and received her son's first check.

In April, Medicaid canceled her universal health care policy because her income level had risen with her son's payments - making her ineligible for the insurance program.

The problem is Jackson Memorial Hospital could not provide the procedure because the risk is too high. The universal policy from Medicaid helps shield the hospital from liability in this kind of case. Without it, they are subject to liability issues.

Even though Smith offered to cancel her son's disability benefits, she was told it's too late.

"She's gone through six months worth of radiation and chemo, her body can't take anymore. If they don't allow her to have this transplant coming up right now next week, they're in effect signing her death warrant," said her friend Tom Noonan.

"I want to live to see my son grow up and get on with my life," Smith told CBS4's Ted Scouten.

After hearing the CBS4 report, State Sen. Dave Aronberg said he was prepared to take action over the weekend. Social Security officials also started looking into the case to make the surgery happen.

Since the CBS4 News report first aired last Friday, several lawmakers jumped in. Late Monday afternoon Jackson Memorial Hospital confirmed Smith will have her surgery later this week after all.
Posted by Ryan (+479) 11 years ago
Interesting. I feel bad for what she had to go through just to get it paid. Hope changes will happen but know it will take time. Maybe..