Family experiences pain of cancer, death and insurance [View All]

[firedupdem]

The 24-year-old father from Elm Creek, a Nebraska National Guardsman, had escaped injury while escorting convoys past roadside bombs during his 12 months in Balad, Iraq. Other soldiers in his unit were less fortunate.
But in skirmishes with a military health care insurer, his luck ran out.
His family was twice ambushed by coverage denials in July - after he was diagnosed with advanced lymphoma, a blood cancer.
It seemed even if he did survive, medical debts would forever dog his family.
Before Dustin died, Heather had wanted their story to be a warning to others, that unexpected insurance denials can be nearly as devastating as a war department telegram.

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Heather suspects their insurer got news of Dustin's stage IV lymphoma diagnosis, saw big expenses ahead and seized upon the technicality that would allow it to run away - she had paid June's insurance premium a few days late.
Others see in the young couple's story examples of the insurance morass that has enveloped this country's medical payment system, its bureaucratic complexities, absence of consumer safeguards, the prerogative of insurers to seemingly make up rules.

"It's a little bit of an example of why we're in this mess now as a nation," said Dr. Mark Hutchins, the Lincoln oncologist who treated Dustin.

There's nothing about the Von Loh case unique to one insurer or to Nebraska, said Stephen Finan, associate director of policy for the American Cancer Society Action Network, which assists cancer patients battling insurers.
Many people don't learn about shortcomings in their policy until they get an expensive disease - a typical stage II breast cancer costs around $110,000, a typical stage III colon cancer, $252,000.
Dustin and Heather, a 22-year-old expecting their second child this fall, learned that insurance problems intensify even the pain of cancer.

"That's all we needed on top of everything," she said.

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Their coverage began in May with monthly premiums of $180.

Heather says she received June's bill - due June 1 - sometime in mid-June and paid it within days. For a while, the lateness of the payment didn't seem to matter.

TRICARE covered her June prenatal visit to her doctor, and on July 2 it authorized payment for Dustin's spinal MRI at the Noble Spine Clinic in Lincoln.

There was no sign of trouble until a claim was submitted after the cancer diagnosis of July 3. TRICARE suspended coverage back to June 1, based on the late payment.


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