Girl With Keen Liver Donor Preventing To Have Uncommon Remedy Lined By Insurance coverage

Woman With Willing Liver Donor Fighting To Have Rare Treatment Covered By Insurance

2021-04-10 03:32:57

CHICAGO (CBS) — After a devastating prognosis, a Humboldt Park girl was determined to discover a remedy that will enable her to see her daughters graduate highschool. She discovered it, however her medical insurance mentioned no twice. 

However CBS 2’s Marie Saavedra began making calls and realized there should be an answer. 

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When Kathleen Lyons and Eileen Womack get collectively, their days on the College of Illinois don’t appear all that way back. 

“She’s simply very vigorous, very caring and a real pal,” Eileen mentioned.

“Her and I have been at all times those up late at evening ingesting our tea, finding out and goofing off,” mentioned Kathleen. “The years go by and we’re nonetheless doing that, so we’ll in all probability go for a cup of tea after this interview. 

However within the years since, life occurred, and it dealt Kathleen a severe blow two years in the past. She was identified with stage 4 colon most cancers that unfold to her liver. 

“I’m shocked I’m nonetheless right here at present, truthfully,” Kathleen mentioned. “It’s not going to remain like that with out another intervention.”

She began chemotherapy, and related with a physician 600 miles away who gave her hope. 

“Their outcomes have been above 60% survival at 5 years,” mentioned Dr. Roberto Hernandez-Alejandro.

He’s chief of transplantation on the College of Rochester Medical Heart in New York. It’s considered one of only some in the US that supply liver transplants for these in Kathleen’s situation with a dwelling donor.

Who knew one of many ladies from faculty, would get in a hospital robe to assist the opposite add years to her life?

“The transplant nurse requested me, she mentioned, ‘Would you wish to name Kathleen or would you want us to?’” Eileen mentioned. “I mentioned, ‘I wish to name her.’ It was superb to have the ability to say, ‘I handed. We’re going to do that!’”

“You already know, it means extra years with my daughters and the whole lot, and it’s simply superb how selfless she is to try this,” mentioned Kathleen.

However that comfortable ending was too simple. Kathleen utilized to her insurance coverage, Blue Cross Blue Protect, to get the surgical procedure coated. 

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“They mentioned no to the preliminary request for the preauthorization of surgical procedure claiming I wasn’t in liver failure,” Kathleen mentioned.

She appealed it, however was once more denied. The process is uncommon. BCBS referred to as it ‘experimental’. 

“It’s not experimental in any respect,” mentioned Dr. Roberto Hernandez-Alejandro.

Thursday, CBS 2 reached out to the corporate for extra about that however didn’t instantly hear again. 

Nonetheless after that setback there may be new hope. Simply as the women have been pulling up for the interview with CBS 2, Kathleen received a name from Blue Cross Blue Protect. She says they informed her they’re new methods to assist her.  

“I’m hopeful. Very hopeful,” she mentioned.

No matter that subsequent step is, she’ll take it with Eileen at her aspect. 

“I actually sit up for the day we really do it and we actually hope it’s quickly,” Eileen mentioned.

Blue Cross Blue Protect responded to CBS 2’s request for extra data Friday afternoon with this assertion:

As a matter of privateness, Blue Cross and Blue Protect of Illinois doesn’t publicly disclose our members’ private or profit data, however as an alternative seeks to work instantly with our members on any questions they might have concerning their protection.

Our members are on the heart of all that we do and we’re dedicated to offering our members entry to high quality well being care according to the phrases of their profit protection and any relevant medical insurance policies. These insurance policies are primarily based on evidence-based requirements of care, together with, when related, the Nationwide Complete Most cancers Community® (NCCN) Tips.

If a member questions a profit willpower, we encourage them to file an attraction for a assessment of the choice.

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For extra data on methods to assist Kathleen’s struggle towards her most cancers, discover her GoFundMe right here.

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