When Your Safety Net Fails

Insurance is our safety net.

It’s our protection against the unthinkable. Our first line of defense when something goes wrong. Our safeguard for our health and our finances. Our security for our family and our homes. Our precaution against all the “what ifs.” Our surety in protection of our resources and access to healthcare and treatment.

On paper, health insurance sounds pretty anticipative and hopeful. It sounds like if an illness or tragedy were to strike, things would be okay in the end – because someone would be there to catch you. But the harsh reality seems to be a security net with many holes and many flaws. In the hands of insurance companies, so many people seem to be falling through the holes of the net, slipping through the worn out spaces, and some even missing the net completely as they fall.

Being denied access to your health benefits, after faithfully paying your dues, can feel like a slap in the face. Where is the security net that was promised? Where is the protection? Where is the treatment?

A recent press release by The Alliance for Proton Therapy Access highlights the urgent need for activism for cancer-related insurance denials, specifically Proton Therapy. “An FDA-cleared cancer treatment that is covered by Medicare, proton therapy has demonstrated effectiveness in reducing excess radiation exposure to healthy tissue while resulting in significant improvement in quality of life for patients with head and neck cancers. By precisely targeting cancer cells, proton therapy is able to minimize harmful side effects while increasing the amount of radiation delivered to cancerous tissues.”

To be dealing with a debilitating illness, and to also be dealing with roadblocks and barriers to necessary treatment, is an absurd but common occurrence. The reasoning behind insurance denials can vary from case to case, but at Kantor & Kantor we frequently see health insurance denials that claim treatment is “not medically necessary” or is “experimental.” According to the Alliance for Proton Therapy Access, the need for fair, timely and transparent access to doctor-recommended cancer treatments is dire.

“While there is an abundance of research showing proton therapy’s effectiveness in treating patients with oral, head and neck cancers, too many patients who would benefit most from proton therapy based on their physician’s recommendation are denied coverage by their insurer,” said Daniel E. Smith, Executive Director of the Alliance. “We must fix this broken review and appeals process to ensure that all cancer patients are able to receive timely, fair and transparent coverage decisions.”

Even when proton therapy is a clinically appropriate treatment recommended by a physician, patients are being forced to deal with complex and restrictive insurance denials – rather than obtaining timely treatment and focusing on healing.

At Kantor & Kantor, our clients come to us with many different types of illnesses. We see clients with Cancer, Lupus, Multiple Sclerosis, Fibromyalgia, (and many more disabilities) all battling both their illness and their insurance company.

You shouldn’t have to fight your insurance company for your safety net, and for the health benefits to which you are entitled.

Let us help you put that safety net back into place.

We understand, and we can help.

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