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Posted on 09/04/2026 9:46:55 AM PDT by DFG
A mother has said she feels 'helpless' and called UnitedHealthcare money-hungry after the insurance company allegedly denied covering her son's rehab for a brain injury.
Peyton Alvarez, a 25-year-old airline mechanic at PSA Airlines, crashed into a tree while riding his motorcycle in Greenville, South Carolina, on April 28.
Although he was wearing a helmet and other protective gear, the collision caused a serious brain injury that left him unconscious for a month and a half. Doctors told his mother, Trina Alvarez, that Peyton may never wake up.
But the young man eventually opened his right eye in early June, and he can move his left arm and wiggle his toes when prompted, Trina told the Daily Mail.
Peyton's mom submitted a claim with her son's insurance plan, managed by UnitedHealthcare through his employer, and she made the arrangements to have him transferred to the Shepherd Center in Atlanta, a top brain injury rehabilitation facility.
But on July 7, Trina was crushed when she received a denial letter from UnitedHealthcare, which stated that Peyton's treatment at the facility was 'medically unnecessary.'
'It is so frustrating. It makes me so angry that they can control what happens with my son because the longer he stays at the hospital he's at, the less chance he has to wake up,' Trina told the Daily Mail.
'When you push a parent to the point of feeling like they are helpless, and may contribute to whether their son may ever be able to talk or move his arms and legs or sit up on his own, that should not be allowed,' she added.
(Excerpt) Read more at dailymail.com ...
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“Like most government functions in America, health care needs radical decentralization. Let localities decide what is needed, and how they themselves will fund it. They will come up with their own ideal local blend of freedom/capitalism/collectivism/socialism.”
I feel the same way about schooling.
Somebody else is going to have pay for whatever demons bite anybody...and they will bite sooner or later!
He crashed into a tree because he was riding a motorcycle.
I agree with you, and I agree with the insurance company denial. The insurer is denying the care facility that Mom is requesting because the patient’s condition is too poor. The insurer is not denying care, they are willing to cover appropriate care in SNF/acute care where PT and OT are available. Mom can rerequest IF her son improves.
Patient has a trach, a g-tube, opens one eye, moves one arm and one set of toes. He has a looooong road ahead and may never be able to eat, walk, talk, read, even watch TV. Sad story, but insurer is correct.
I was also wondering why this is not about motor vehicle insurance, but he probably blew through whatever coverage he had a long time ago considering the severity of the reported injuries / lengthy hospital stay.
Could be the abject stupidity of another driver, or their callous prioritization of clicking a heart emoji on a funny cat video while ‘driving’.
Yes. That would be my guess as well. It’s not like a journalist might ask that question and express the facts for public benefit.....
It said it was managed by United Healthcare through his employer, but I agree with you. I thought they just had senior plans.
Right up there with equestrian events riding. A medical mess that presents itself with absolute certainty.
rehab is “medically unnecessary?”
what a crock of Sheit!
Whatever insurance company that is deserves to be reported and hopefully shut the F down!
> There’s no reason ever to choose Medicare Advantage. <
Like I mentioned earlier, I did my research. The best advice I read: Choose an Advantage plan only if you are very poor and very healthy.
The trick is of course is the “very healthy” part. You could be very healthy today, and be dire straights tomorrow.
Motorcyclist… rock climbers… parachutists… cliff jumpers… all risk takers.
Then first responders get to clean up the mess? Why?
Guilty of all those things. AMA professional motocross racer, and bull rider can be added to the list. Some people crave excitement. If you don’t, then you would never understand.
As a former first responder and volunteer firefighter, I feel safe in saying most are adrenaline junkies.
When I call my climbing friends in Colorado that are SAR they are always ready to climb in the backcountry when not on call. They train for the job. They enjoy the job.
I have always paid my insurance premiums. I may die in a climbing accident, but I prefer that to sitting on the sofa drunk, 50 pounds over weight, with clogged arteries.
My wife and I have had United Healthcare for four years now. We are both 69 years old. On Thanksgiving day I went to my local hospital and then was sent to Indianapolis for a blood clot in my leg. And I had blood clots in both lungs. They did surgery, etc. for five days.
The bill was somewhere around $140,000 or more. I ended up paying $1700 out of pocket. United Healthcare covered all the rest. I’m not sure where all the hatred toward them came, especially since there was a lot of celebration after their CEO was assassinated.
Have you had United Healthcare or are you just repeating stories that you had heard?
I filed and won about a dozen appeals on their denied care. When they dug in, I investigated them and found that the Dr’s they hired to reject the care were reviewing claims outside their medical specialty, I threatened to file malpractice claims against the Dr’s.
The worst was that the Medicare advantage plan had 100 days of rehab coverage, and while my client was in care, they cut it to twenty days and denied her the 100 days she was entitled to have.
I am the power of attorney, both durable and medical. In this case it was not worth fighting United Healthcare as Medicare kicked in to pay the remainder of days.
I researched the whole claims approval system and ownership of the independent reviewers (Carlisle Group (Frank Carlucci and the Bushes)) and found it was corrupt beyond words of description.
It is easy and basically automatic to go from a Medicare supplemental or gap policy to an advantage plan. To go from an Advantage plan to a supplemental or gap plan is not easy, requires medical underwriting. That is all you need to know in my opinion. Keep in mind, in this life we get what we pay for. Pay little, get little. Pay more, get more. Sometimes we need to look beyond the tip of our noise.
May I say this? We, my spouse and me, worked to age 69. Both of us. For three reasons we didn’t retire at 62. One of those three reasons was to avoid a Medicare Advantage plan. We worked 7 x 2 years to avoid this.
Do we even know if he was driving uninsured ??
The hardest battles to win are coverage for rehab relating to stroke.
One has to appeal these things, multiple times if necessary. I’ve been through similar rejections.
Several opinions from more than one doctor and having him declared disabled within their state can help, and there are lawyers who take cases like this pro-bono, because denying that is ridicuous. Of course it’s, “medically necessary.”
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