Oregon Insurer Denies Cancer Patient Treatment
Barbara Wagner’s doctor had unfortunate news when he informed her that her insurance company, Oregon Health Plan, had denied her claim for necessary treatment. The 64-year-old Oregon woman has lung cancer that had once been in remission, but has since returned. Barbara’s doctor had prescribed her with a drug to help battle the disease. The only problem was the medication would cost roughly $4,000 a month.
Barbara’s insurance company ultimately denied her coverage of the drug and, instead, offered her coverage for a $50 drug that would assist her in death. Oregon Health Plan decides whether or not to provide coverage for a case like this based on a minimum 5% survival rate after five years. Considering Barbara did not qualify and the drug she was requesting would extend her life expectancy indefinitely by six months with a very high chance of longer, the company denied her and instead offered her the option of a faster death.
In another instance, Randy Stroup 53, who suffers from terminal prostate cancer, recently learned that his doctor’s request for the drug mitoxantrone had been rejected. The treatment, although would not completely cure him, would decrease his pain and extend his life by roughly six months. Randy says, “[w]hat is six months of life worth? To me it’s worth a lot. This is my life they’re playing with.” It is alarming when insurance companies are deciding on treatments as opposed to the patient’s physician. When a policyholder pays their whole life for coverage, they should receive the necessary treatment when they need it the most.
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