Insurance company denies Arizona man battling cancer
PHOENIX (CNN, KYMA/KECY) - An Arizona man battling cancer says his insurance provider has denied an important part of his treatment.
"Our insurance is throwing a curve ball at us like this and I've got days to solve it. It's unacceptable," said Gary Schmit, who says he's running out time to get the radiation therapy he needs to fight his throat cancer.
His wife, Serena, says his insurance, Anthem Blue Cross Blue Shield, is denying their claim.
"They deny it as if they know more than our doctors at the Mayo Clinic know about what is best to treat his cancer," Serena expressed.
Schmit says his treatment plan started with surgery to remove his tumors. Anthem signed off on that procedure, but not the radiation that follows.
"It doesn't make sense that they're almost à la carte my treatment. It's cancer treatment," Schmit remarked.
He explains the radiation is only effective if it happens within six weeks of surgery. That was a month ago, and because of a rare complication, Schmit says everything was pushed back even before the denial.
"I didn't know if he was going to make it. It was scary, scary. And so it's just it's been a lot to go through. gets emotional," Serena said.
Schmit says he's doing better and the tumors are gone. His medical team tells him it's time for the next step.
"It's not like somebody wants to get radiation, you know?" Serena added.
"If I don't have the radiation treatment, there's a 20% more chance that the cancer returns. So they're messing with 20% more of of my life at that point," Schmit declared.
In a statement, Anthem says the radiation requested is not medically necessary to treat this form of cance, but Schmit says his doctors disagree and out of pocket, treatment could cost nearly $250,000.
"Something seriously wrong with our health care system if the health insurance companies are dictating what kind of treatment we're receiving over the specialists, the experts," Schmit spoke.
An additional setback amid a difficult diagnosis.
"All that turmoil, you have to deal with the cancer, but then also the rage that you feel at just being a number on the back end and it's like this is like this is somebody's life," Serena further expressed.
Anthem Blue Cross Blue Shield released a statement, saying in part: "The requested service was denied due to the particular type of radiation requested not being medically necessary to treat this form of cancer. Anthem continues to work with this member to ensure he receives clinically appropriate and medically necessary care."
