Instead of Focusing on Chemo, One Woman Spent Hours Arguing with Insurer over Coverage
Arete Tsoukalas, 26, was diagnosed with leukemia three years ago and had to spend hours on the phone arguing with her insurer to get coverage for the medication she needed. The recent college graduate was stunned to learn that her insurer’s coverage came with a $13,000 monthly copay, which she could not afford. She was forced to go without the medication for three months before she could obtain it through the drug manufacturer’s assistance program.
Tsoukalas is not alone in her struggles with the nation’s health insurance industry. The fatal shooting of UnitedHealthcare CEO Brian Thompson has sparked a wave of outrage on social media, with people sharing their own stories of denials of medical treatments and claims, as well as other frustrations with the system.
A KFF survey found that the majority of insured US adults have at least one health insurance problem, including denial of claims, in a year. Despite this, 81% of respondents rated their health insurance as “excellent” or “good”. More than 200 readers have written to CNN with their own experiences, including problems with getting treatments and care denied, receiving unexpected medical bills, and getting the runaround when trying to resolve issues.
Some Americans feel they have no choice but to get the care their doctors recommend, even if their insurers deny it, resulting in massive bills. A KFF analysis found that people owe at least $220 billion in medical debt, and a 2022 survey found that 41% of adults have debt caused by medical or dental bills. One woman, Melanie Duquette, 70, was left with a $14,000 bill after her insurer refused to pay for her extended stay at a rehab center following back surgery. She is now worried she may have to declare bankruptcy.