Policyholder Fighting Health Net for Coverage Gets Temporary Reprieve Because of Media Involvement

Suppose you are dying from cancer, but instead of putting all your energy into fighting the disease, your biggest battle is with your health insurer for treatment to keep you alive. That’s what Westlake Village resident Bob Iritano is up against, reports Los Angeles Times business columnist David Lazarus.Click- “Fighting Cancer and His Insurer.”

After a round of chemotherapy that almost killed him because of an allergic reaction, Iritano’s doctors recommended a procedure called radio frequency ablation that, while it won’t cure his cancer, will temporarily eliminate his tumors and decrease the painful symptoms of his disease. The procedure, which Iritano much undergo every time his tumors grow back, was initially covered by his health insurer Health Net. But when he scheduled treatment again six months later, coverage was denied.

Iritano found out about the denial only minutes before the procedure was scheduled to begin. He was already robed in a surgical gown when he was told Health Net had deemed the procedure “experimental” and would no longer pay for it. Iritano’s physicians scoff at the notion, asserting that the treatment has been proven effective for more than 10 years.

Lazarus contacted Health Net to inform the company he was writing about Iritano’s case. A few days later, Iritano received a letter authorizing the procedure just one more time. But he wasn’t to expect the company had changed its policy about the experimental nature of the treatment.

“My best guess is that they want me dead as soon as possible,” Iritano told Lazarus. “They know that the premiums I pay will never cover how much they’ll spend on me.”

Wow.

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