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A couple who followed a doctor's advice to transfer their baby son to a hospital by plane for critical care have been hit with a $97,000 bill, as KFF Health News’ Molly Castle Work reports.
Three-month-old Amari, who had open-heart surgery at just one month old, was struggling to breathe. The parents took Amari to the ER at Natividad Medical Center in Salinas, Calif., where doctors determined he should be transferred to a major hospital for specialized care, immediately.
The child had health insurance, and the parents expected the 86-mile air ambulance flight to be covered. Amari was diagnosed with RSV and recovered after a 3-week stay at a hospital in San Francisco.
But his parents were shocked to receive a bill for $96,599 from the air ambulance company – none of which was picked up by the family’s health insurance. The insurer determined the flight was not “medically necessary,” claiming Amari could have made the journey in a ground ambulance.
As frustrating as “medical necessity” denials are, it’s worth going through the steps to appeal them, says Patricia Kelmar, a health policy expert. Patients who appeal have a high likelihood of winning, Kelmar says. And if the insurer rejects your appeals, she recommends pushing forward to an external review so someone outside the company has a chance to weigh in.
Learn more about Amari’s story and what you can do if your health insurance decides your care was medically unnecessary.
Do you have an outsized or inscrutable medical bill? Share it with NPR and KFF Health News, and help us help people learn how to be more active and successful in managing the costs of their care. |
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It’s difficult, and perhaps a little cruel to analyze how the British royal family erred in the way they chose to handle the Princess of Wales’ cancer diagnosis vis a vis the public. It’s a fair bet to say it didn’t go the way the Palace would have wished, what with the wild speculation about Kate’s whereabouts, stoked by the release of a doctored photograph of the princess and her children.
Then last week, she ended up telling the whole world that she had cancer and was receiving chemotherapy, and entreating the public for privacy in the same short video.
No matter who you are, deciding when, how, and with whom to share a cancer diagnosis can be daunting. NPR digital editor Marc Silver’s wife Marsha was diagnosed with breast cancer back in 2001, and he’s spoken with dozens of people who’ve coped with cancer for the books Breast Cancer Husband and My Parent Has Cancer And It Really Sucks. This week, he’s sharing some of what he’s learned about how to talk about a new cancer diagnosis.
Here are a few of the suggestions he gathered: - Figure out how much you want to say. You might have a 2-minute script for casual acquaintances and a 20-minute version for those you hold closer.
- It’s a good idea to be honest with children, but plan when and where you tell them. In the car is a good place to do it, therapists told Silver, because you don’t need to make eye contact, and the kids can’t run to their rooms.
- When it comes to sharing with people outside of the family, the person with cancer is in the driver’s seat
- Opening up about a diagnosis can bring good things, as Marc and Marsha learned. “For every unfortunate remark, there were just tremendous waves of love that we basked in. I still remember how our neighbor brought over the most incredible tuna casserole for dinner one night,” he writes.
Get more advice and perspective on communicating about cancer from experts and patients here.
Plus: How to talk to kids about a cancer diagnosis in the family |
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We hope you enjoyed these stories. Find more of NPR's health journalism online.
All our best,
Andrea Muraskin and your NPR Health editors |
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