Posted on 02/28/2025 9:20:18 AM PST by Red Badger
OGDEN, Utah (KUTV) — An Ogden man has been denied a lifesaving liver transplant from his brother by his insurance company.
Nathan Kirkland discovered he had bile duct cancer in April of 2024 while his wife was pregnant with their second child.
"Our cancer journey started in Utah. I was told I might not see my daughter born in August,” he said.
The news devastated his family as they tried to figure out what to do next.
"Should we just be taking the trips that we always talked about, should we be trying to make the most out of every minute. We made some tough decisions at the time and decided we weren't going to accept that outlook,” Kirkland said.
He underwent numerous treatments for cholangiocarcinoma — bile duct cancer — but has reached his limit on chemotherapy. The next option is getting a new liver.
For many, a liver transplant can be a cure for hilar cholangiocarcinoma, but there is a risk that the cancer will recur after a liver transplant.
He had already beaten the odds by surviving way longer than doctors expected, and now could be on his way to a cure: a life-saving liver transplant from his brother.
There was one battle he wasn’t expecting.
"I've been battling insurance every step of the way. So, this latest battle is insurance trying to make a decision about my life for me. Through this process we learned it takes a lot of time with insurance, and we just don't have time anymore,” Kirkland said.
He said the insurance had been approving them all the way up until they got to the transplant, which had already been scheduled for February 14.
Since the denial letter on February 6, 2025, they’ve been reaching out to Anthem Blue Cross Blue Shield for answers.
"It's just non answers. We asked for the evidence of why they denied us and we're not getting those documents, we're not getting those answers,” he said.
They shared their story on Facebook, where it has been gaining traction.
Kirkland and his family are on their way to Pittsburg for the transplant Friday. They are stilling waiting to find out what insurance will cover.
KUTV reached out to Anthem Blue Cross Blue Shield, and they said this is a matter of HIPAA authorization, something we are coordinating with the family.
UPDATE:
Insurance company approves liver transplant after first denying $800K surgery, family says
And then they have the audacity to be surprised when Luigi walks in....
This guy got what he needed without shooting someone to death :)
That probably should be down the list on actions to take!
but there is a risk that the cancer will recur after a liver transplant. If there is a comorbid condition such as cancer in the arteries (angiosarcoma or ELSD), or some other infection that is still present (even a dental infection), the UNOS will not register a person for a transplant. The theory is that there is a low probability of success after 5 years, and the second is it takes away a potential liver for a more survivable candidate. It is disappointing if the potential recipient is told that he or she is not eligible for transplant, but it is good system overall, in my opinion.
Yes, 800k is expensive as hell, but the actuaries long ago figured that into the premium. On average there are 4 liver transplants per 100k people, our deductible is X, our co-pay is Y, so we charge Z for a male aged 40, etc etc.
The insurance company took the money, so they takes their chances.
That’s such good news! I don’t even know these people, but after reading his story, I feel like rejoicing that at very least, he will be getting his liver transplant now.
Prayers for recovery, so he can spend more time with his wife and new baby. This reminds me that each dawning day is a gift! Yes, I do require frequent reminding.
this one can be rough, and very quick for some people.
Almost three decades ago, my son was diagnosed with WPW and needed either open-heart surgery or a new procedure called “catheter oblation”. The open-heart surgery back then was a 6-week recovery time whereas the new procedure threaded the probes through the femoral artery and into the heart to oblate the false path. Recovery was a couple of days. Although experimental, we opted for the oblation. The expected cost was $50,000, but a fraction of the open heart option. Blue Cross-Blue Shield denied the request stating that it was “experimental”. I told this story to very good friend who said: “Do the surgery. I’ll pay for it.”
Long story short: My son was the first non-adult to have the surgery which was a success. Three weeks before the surgery, BCBS said they would honor the claim. They are not always on the bad side of the story.
Oh I agree... and you ain’t gonna get that transplant in the prison anyway. I’m not sayin’ what Luigi did was right, BUT it does seem these health insurance companies are a -little- more willing to listen to reason these days!
As Al Capone said, you can get further with a kind word and a gun than you can with justa kind word.
His Doctors said he was a candidate, and had him scheduled.
I have had that.................
The important question is of he has all of his covid boosters.
He should have been taking Vitamine D, Ivermectin and Menbenazole with his chemo and he probably would not need the transplant.
https://www.sciencedirect.com/science/article/pii/S1043661820315152
There's your answer.
It’s a tough business but it’s insurance not an open healthcare ticket. People don’t like to hear this but insurance is a contract. The insurance sets premiums based on the terms of the contract. And those terms must be enforced or costs will exceed premiums. But the vast majority believe some one else should pay for their health care no matter their personal choices or their medical condition.
Does anyone on this forum believe their are circumstances were the insurance company should not cover a treatment?
The insurance company sets the terms, the customer abides by those terms, and the insurance company arbitrarily changes the terms with no notice. Sounds fair...
Insurance companies have a bad name for a reason. They are more than happy to take your premiums, but the moment you put in a claim they will move heaven and earth to avoid their responsibilities and commitments.
Insurance companies don’t have responsibilities and commitments they aren’t spouses or family members. What they have and so does the customer are contractual obligations. No more no less. If you cannot accept the terms of one find another. Or go without. I do.
Most people don’t read their policies and just expect claims to be paid on their need or expectations.
The vast majority of insurance companies do their damndest to avoid their contractual obligations by altering the terms and conditions without input from their customers, often removing the key contracted provision the customer was forced into purchasing a policy for in the first place.
Defend the liars and thieves all you want, they are still crooked as a dog’s hind leg at the best of times.
The ONLY reason they still exist is because the government FORCES the public to purchase the product on pain of further financial punishment.
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