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Man denied life-saving surgery over 26-cents

new jersey insurance dispute myelogenous leukemia bone-marrow transplant cobra program

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#1 Hum

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Posted 14 August 2013 - 12:32

A man seeking treatment for a life-threatening illness had his health further jeopardized when his employer and health insurance company tried to cancel his coverage over a 26-cent dispute.

The New Jersey Star-Ledger reports that in January, 33-year-old Sergio Branco was diagnosed with acute myelogenous leukemia. Left untreated, the illness can be fatal.

When the truck driver took time off work to seek treatment under the Family and Medical Leave Act, he was told that treatment for the leukemia required a bone-marrow transplant that would cost about $500,000, even with insurance.

To make matters worse, when Branco returned to work after his federally guaranteed leave time, he was promptly laid off.

Branco and his family weren’t worried, because they knew he was eligible for extended coverage under the government’s COBRA program.

The family also launched a fundraising site for Branco’s leukemia treatments.

The monthly fee for Branco’s COBRA insurance is $518.26. When his wife sent in the first payment, she erroneously made out the check for $518, forgetting to add the 26 cents.

Thus began an extended feud among the family, Branco's former employer Russell Reid, the insurance company handling his COBRA and even the Department of Labor.

Paychex, the company handling the COBRA payments, cashed the check but did not notify the Branco family of the payment error. In the middle of Branco’s treatment, he was informed by the hospital that he didn’t have insurance.

"They’re playing with my husband’s life," Mara Branco told the Star-Ledger.

Technically, the payment was still not due. So the Brancos offered to make up the difference, but they were told that his former employer had instructed Paychex to not accept any further payments — meaning that his COBRA insurance would be canceled.

"The whole time he said Paychex is giving me false information," Mara Branco told the Star-Ledger after she contacted Branco’s former employer. "I told him if he’d just make a phone call everything would be all right. He said he’d see what he could do."

Branco’s wife even enlisted the help of the Department of Labor, whose representatives made four calls to her husband’s former employer.

Eventually, the family hired a lawyer and Branco’s physician got involved, sending a letter pleading for Branco to be added back onto his COBRA plan. Branco “will most certainly die in the very near future if he does not proceed to transplant; therefore I am writing to request that every effort be made to reinstate his health care insurance coverage," the doctor wrote.

"They know he’s literally in a life and death situation and for 26 cents, they’re denying him the right to get the health insurance coverage he needs," attorney Jeffrey Resnick told the Star-Ledger.

It took several months, but on Aug. 9, the parties involved finally agreed to put Blanco back on the COBRA coverage. Blanco’s surgery is now scheduled to take place on Friday.

"The Department of Labor said the company will reinstate him from May 'til now," Mara Branco told the paper. "They said the company did it wrong. I am super happy. It’s like a weight has lifted off my shoulder. It’s better than winning the lottery."

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#2 Ph1b3r0pt1c

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Posted 14 August 2013 - 12:53

Yep, but not a single problem with the 'health care' in the US. IT WAS A .26 CENT MISTAKE YOU GREEDY ######.



#3 OP Hum

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Posted 14 August 2013 - 12:55

SUE ! It's the American way. :laugh:



#4 McKay

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Posted 14 August 2013 - 13:00

SUE ! It's the American way. :laugh:

 

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#5 Nashy

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Posted 14 August 2013 - 13:02

###### some evil ###### happens in the US.



#6 Torolol

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Posted 14 August 2013 - 13:05

evils loves moneys.



#7 HawkMan

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Posted 14 August 2013 - 13:27

Soon there will be people in here complaining that Europeans are derailing the thread to talk about how bad US healthcare is compared to Europe again. ;)

Never mind the fact the guy needed to have two expensive insurances to have a life saving surgery.had to fight for one of them because the payment system didn't inform hi of minor error and the insurance company didn't inform him he wasn't insured... So to getthesurgery he would need to get a loan he could never pay and thus would never get...


Wake up. Your health system if broken beyond repair. Patching it with forced insurance isn't good enough.

#8 Praetor

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Posted 14 August 2013 - 13:42

This news just disgusts me, when a man's life is in jeopardy for a mere $.26.



#9 +LogicalApex

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Posted 14 August 2013 - 13:50

I can't say this enough. Health Insurance should never be coupled with employment like it is here in the US. This should have been an issue between him and the insurance company... Not the employer souring everything in an attempt to lower their insurance costs next year...



#10 Astra.Xtreme

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Posted 14 August 2013 - 13:56

Wake up. Your health system if broken beyond repair. Patching it with forced insurance isn't good enough.

We're all awake and are aware the health system here is shoddy.  Having the government step in is going to make it a hundred times worse.

There's way too many people in this country for any sort of system to work, but the worst problem is that the costs of healthcare are out of control.

 

But good luck telling multi-billion dollar companies to settle for less money.  It basically won't ever happen, and we all just have to deal with it.  Capitalist America at it's finest...



#11 watkinsx2

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Posted 14 August 2013 - 14:05

Profit should never even come in to it when someones life is in danger.



#12 OP Hum

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Posted 14 August 2013 - 14:16

Insurance companies should be taken out of the health care equation.

 

All legal citizens go on Medicare.



#13 vetsanctified

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Posted 14 August 2013 - 14:20

Welcome to capitalism.



#14 Rohdekill

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Posted 14 August 2013 - 14:29

I can't say this enough. Health Insurance should never be coupled with employment like it is here in the US. This should have been an issue between him and the insurance company... Not the employer souring everything in an attempt to lower their insurance costs next year...

You take the employer out of the equation and your health insurance cost alone would kill your paycheck.  The employer is paying nearly 50% of your insurance premium. So, they have a say.  Unfortunately, that say entitles them to try and save every nickel and dime, such as this case.

 

The problem will never go away until health care becomes a service, not a business.  But, to do that hospitals, ambulances, and drug companies would all need to convert to a government service.  It just isn't going to happen with the greedy 1%.



#15 cork1958

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Posted 14 August 2013 - 14:31

This news just disgusts me, when a man's life is in jeopardy for a mere $.26.

 

 

I could not agree more!!  :angry:

 

Of course,

We'd be here saying the same thing if it was $26 or $2600 and it was life threatening! At least we SHOULD be saying the same thing!!





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