Monday, August 12, 2013

Life-saving transplant denied and health insurance canceled over 26-cent shortfall


http://www.rawstory.com/rs/2013/08/12/life-saving-transplant-denied-and-health-insurance-canceled-over-26-cent-shortfall/

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Twenty-six cents almost cost Sergio Branco his life.
Twenty-six cents.
"He complained about bone pains and being extremely fatigued," Marujo said. "He decided to go to the emergency room."
A few days later, a bone marrow test confirmed the diagnosis: acute myeloid leukemia. The disease, left untreated, travels fast and can kill within months, or even weeks, of diagnosis.
and now comes the double wamy of insurance and reality.
Branco started a series of treatments including chemotherapy and transfusions, and he took three months off from work under the Family and Medical Leave Act (FMLA).
Doctors soon said he’d need a bone marrow transplant to prolong his life. They found a 10-point match — the best possible match. The transplant and related care for the disease would cost more than $500,000.
But when his three-month leave under FMLA ended, Russell Reid fired him, Branco’s family said.
At least they’d be able to continue health insurance coverage through COBRA, short for the Consolidated Omnibus Reconciliation Act. Under COBRA, a terminated employee can continue the same health insurance coverage he had while employed, but the terminated employee is responsible for paying the full premium.
Branco was fired on April 30, so he had until June 30 to decide whether or not he wanted COBRA. After that, the payments would be due.  The Brancos received a notification letter, dated May 1, which said so.
The cost would be $518.26 per month.
So on or about May 24, Mara Branco filled out the paperwork and mailed a check to Paychex for the first month of coverage.
She wrote the check, dated May 24, for an even $518, inadvertently missing the 26 cents.
Paychex cashed the check on June 11.
That’s when she was told for the first time that the payment was 26 cents short. Paychex didn’t offer an option to bring the payment up-to-date, Mara Branco said.
"They’re playing with my husband’s life," she said.
CHANGE OF HEART
Then things changed late Friday.
"The Department of Labor said the company will reinstate him from May till now," a relieved Mara Branco said. "They said the company did it wrong. I am super happy. It’s like a weight has lifted off my shoulder. It’s better than winning the lottery."
Branco said Paychex told her she could mail payments for May, June and July and she would receive more paperwork about the August payment.
or fear of bad publicity and court would make clients skeptical about their own coverage and create a avalanche of leaving clients.