Cancer Patient Loses Coverage For Earning $4.25/Month Too Much

Over at the Phoenix New Times, they have the harrowing story of a young man who endured multiple surgeries and treatments for a rare type of brain tumor — and who was told by his health plan that they could no longer cover him because he and his wife had earned $4.25 too much to qualify for aid.

The tumor and subsequent surgeries had made it impossible for the man to work and his wife’s part-time job was not sufficient to pay for health insurance. So when he first entered the emergency room in October, both he and his wife were enrolled in the Arizona Health Care Cost Containment System (AHCCCS) which paid for the sky-high hospital bills.

However, in January they received a notice from AHCCS that they had been dropped from the program because they had earned a combined total of $612.25 the previous month; the threshold for AHCCS coverage is $608/month.

That meant that the couple would now be on the hook for the husband’s $8,227/month bill — just for his medication.

Not shockingly, when they took up arms against AHCCS, they found themselves bound up in all manner of red tape and ineptitude:

We were told by one person to do one thing — by someone else to do another… There’d be all these paperwork hoops. We’d send things in three times. They’d say, ‘We never got that. You’re lying.’ Or, ‘It’s processing.’ We’d call back a week later. ‘It’s processing.’ The week after that? ‘We never got it. You’re lying.’

After several months of bashing their heads against the wall, AHCCS finally gave in and put the husband back on the program.

His wife, however, was not re-added. The reason? During the stoppage in her coverage. she had stopped taking some medications she could no longer afford. Thus, she was unable to prove to AHCCS that her medical bills had been at a level that requires assistance.

‘Til Death Do Us Part: They Got Married. Then Everything Changed [Phoenix New Times] (Printer Friendly Version)