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When Insurance Refuses a Breast Cancer Patient

Guest blogger, Carol Dunlop is certified through FiTour as a Personal Trainer and through the American Red Cross as a CPR, AED and First Aid Instructor. She has competed and placed in several Fitness America and National Bodybuilding competitions. Carol was diagnosed with breast cancer in the summer of 2011 and she is sharing her story of survival at DietsInReview.com. Check out her website, OptimumBodySculpting.com.

Can you imagine anything more devastating than being diagnosed with breast cancer? How about finding out that your insurance company is refusing to pay for your treatment? And that no one in the company can give you any solid or sensible answers as to why?

Now that you’ve gathered your breath from the shock, this exact scenario is what has been playing out in my life and breast cancer journey since I was diagnosed four months ago.

Everything started off normal, as normal as you can get in dealing with a shocking diagnosis anyway. I found the lump in a monthly self-exam, called my doctor, had a mammogram and a couple biopsies that came back as cancerous. After that initial shock, I found a great breast surgeon, plastic surgeon and medical oncologist and began treatment. Everything proceeded as it was supposed to until my oncologist informed me that my insurance company was denying payment for my port placement and chemotherapy treatments. What?

How could this be? I had insurance and was covered through my husband’s job, no problem, right? Wrong! They were trying to say that the cancer was pre-existing.

Okay, so now I’m outraged. Here I was a perfectly healthy woman who had only seen one or two doctors once per year for my annual checkups and exams for the last 20 years or so and now, when I need the insurance company most, they fail me. I’ve paid thousands of dollars into insurance over the years and they certainly had no problems talking my money. However, when I need them to pull up to the pump and do what they’re supposed to do  – take care of me in my time of need – they totally bail.

In addition, each and every time I call the insurance company to “discuss” why they are shirking their duties, they all of a sudden act like deer caught in the headlights. No one can answer my question of why this is happening or how and when it will be resolved. Each time I call them, it always ends with “it’s taken care of.” However, the claims are never paid. Then I have to call back and start all over again.

I’ve heard of similar situations, but never had to deal with this type of non-service before. My next step is the news media and then the insurance commissioner. I am certain that if they won’t listen or react to me, they will react to having their name in the media in a negative light.

Hopefully I won’t have to resort to those actions, but my finger is on the “Go” trigger and I won’t hesitate to fight for my rights.

For more on Carol’s breast cancer survival story:

Consistent Physical Activity Aids Breast Cancer Recovery

Breast Cancer Isn’t What’s Going to Take Me Out

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December 5th, 2011

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