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

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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.

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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...

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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...

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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%.

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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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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.

Two?

 

No, one.

 

COBRA extends employee coverage for some time after being laid off.

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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%.

Been paying for health insurance without employer for several years.  Its about 200 a month for my entire family.

 

So it doesn't have to eat your paycheck although in most cases it does.

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Been paying for health insurance without employer for several years.  Its about 200 a month for my entire family.

 

So it doesn't have to eat your paycheck although in most cases it does.

I pay $185 a month, just for me, on the cheapest plan out there where I have to pay $100 out of pocket for ER visit, $20 just to see a doctor.  That's with my employer paying in.

 

And, the insurance only covers certain items.  Plus, if I see a doctor outside of plan, those out of pocket expenses double.  None of this is uncommon with most insurance plans, unless you opt for the highest price selection.

 

Take this, add into account cost for prescriptions and you could go broke in no time.  

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

 

All legal citizens go on Medicare.

 

You know that Medicare is an insurance company? And that they deny a greater percentage of claims than any other insurance provider in the US?

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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...

 

Medicare and Medicaid works fairly well, and the government has been cracking down on fraud to the tune of hundreds of billions already which is nice to see.

 

I see Obamacare as a step towards a single-payer system.  Right now, we're starting to see a separation of insurance from employment, because businesses can no longer afford to provide insurance to employees.  It's a bit of a gamble, but the hope is by separating insurance from employment, that gives workers more freedom to change (or, forces them to change [depending on your view :P]) work and find better paying occupations.  Plenty people I know who graduated college only work the jobs they were given because of the benefits available to them.  If they lost those benefits, they would be searching for a better paying job immediately.  Whether they find better paying jobs though, that will be a different story..

 

When you finally separate insurance from employment, and everyone is forced to have insurance (or pay a fine), the government could then theoretically step in and offer an insurance plan of its own to compete with private insurance companies.  The government doesn't need to profit, it just needs to break even; after all, the government serves the people.  Private insurance companies serve their CEOs, stockholders, creditors, employees, then the people.

 

It will essentially be Medicare for all, which is what we should've had from the start.  Everyone has "skin in the game" so to speak, and every taxpayer has a responsibility to be healthy since they and everyone else are paying for it (rather than a faceless insurance company).  Heck, maybe even refund a bit of the monthly premium if you pick up healthy habits that reduce the healthcare costs for the government in the future.

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You know that Medicare is an insurance company? And that they deny a greater percentage of claims than any other insurance provider in the US?

 

Keep in mind that (up until recently) private health insurance companies would drop your coverage if you had a pre-existing condition.  Dropping coverage /= denying a claim when it comes to those statistics. If you are dropped, how can you be denied? Had those people not lost their coverage, who knows how many claims would have been denied.

 

Also, keep in mind you can appeal a denied claim with Medicare and bring it up with a judge.  Can't do the same with private insurers.. their word is the final word.

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I pay $185 a month, just for me, on the cheapest plan out there where I have to pay $100 out of pocket for ER visit, $20 just to see a doctor.  That's with my employer paying in.

 

And, the insurance only covers certain items.  Plus, if I see a doctor outside of plan, those out of pocket expenses double.  None of this is uncommon with most insurance plans, unless you opt for the highest price selection.

 

Take this, add into account cost for prescriptions and you could go broke in no time.  

I'm not disagreeing with you.  I am just saying, it doesn't have to be that way and illustrated it with my own insurance.  Granted, mine isn't great, but its better than what I have had employers offer.

 

The problem is, affordable insurance companies are few and far between.

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Keep in mind that (up until recently) private health insurance companies would drop your coverage if you had a pre-existing condition.  Dropping coverage /= denying a claim when it comes to those statistics. If you are dropped, how can you be denied? Had those people not lost their coverage, who knows how many claims would have been denied.

 

Also, keep in mind you can appeal a denied claim with Medicare and bring it up with a judge.  Can't do the same with private insurers.. their word is the final word.

I've appealed to private insurance companies before.

 

It didn't help, but they do have an appeal process.

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I've appealed to private insurance companies before.

 

It didn't help, but they do have an appeal process.

I had to once before as well. It was a weird situation though...I have had allergy issues since I was a kid. I got my own insurance after college and I was working as a contractor. They covered allergy related stuff for about a year, then stopped covering it suddenly since it was a 'pre existing condition'. After a quick chat with them they covered it again. Luckily I switched jobs and had insurance through my employer after, no more worries on that stuff!

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