Will your insurance company pay for the treatment your doctors recommend? They may not. That’s what a single mother from Chico said she found out.
In late April, Shelly Andrews-Buta was scheduled to undergo treatment for breast cancer that had spread to her brain, threatening her life.
The experience has been emotionally devastating. “I have two beautiful children, you know, I’m a single mom, they need me to be around,” Andrews-Buta told CBS 5 Investigates.
But instead of having doctors working to remove her brain tumors on the day the surgery was scheduled, she sat in a San Francisco hotel room. Why? Because at the last minute, her insurance company, Blue Shield, decided it wasn’t going to pay for the treatment her doctors at UCSF Medical Center had recommended.
I can tell you why they won't pay without even reading the article- and if I'm wrong I'll eat a booger. She has about a 2% chance of a five year survival rate. Any procedures besides hospice/palliative care would be a waste of money regardless of who pays for it.
you made me go back and read the article, and it turns out Blue Shield won't pay for the more expensive doctor recommended surgery, but they will pay for a cheaper surgery . so it has nothing to do with survival rate.
Keith I also read the article after my asenine sounding outburst. It will still center around survival rate- as she has none. The insurance company might have a hard time doing nothing for several different reasons but, if they do something that offers essentially the same survival rate then it ought to be a defensible situation for them.
Every decision about cancer treatment is based on survival rate tables where other disciplines might have other factors (pain control, functionality, quality of life,reproductive function etc etc etc)
One point I wanted to get across regardless of what anybody thinks about healthcare in this country: whether it's a right, a choice, an option, privately payed or government subsidised this woman is living on borrowed time and will be dead in less than 5 years regardless of what is done and who pays or does not pay. It is not the big, bad insurance companies fault.
Enter text right here!
Uh…Kilron…just like the insurance companies around this great nation, you are assuming the position of a Dr….I am in the medical field, I deal with Insurance red-tape and denials and the only ones that benefit from this is the insurance companies…We must focus on what is right. Buy a policy, pay your premiums, get the care…Period. Well-care is what we are lacking due to Insurance Companies forcing Dr.'s and Patients to go to certain Patient groups and Dr. Groups…blah…Blah…no she is in need of one more day, week year with her family and these fat cats become the decider…..I miss my grandmothers, I wish I had one more day….I miss my grandfathers..to just have one more day…and they died of natural causes!. I have seen miracles beyond medicine and I have seen stats change. Percentage of life -rate vs death rate is for who…you, me…nope…just insurance companies….Good try Kilron, and thanks for your expert opinion.