Terminal Cancer Patient at Center of Health Insurance Nightmare


John Oberg emailed Alexander requesting the form that evening so that Alexander could speak freely, but Alexander did not respond to the request or send the form for Karen Oberg to sign.

Instead, Alexander emailed the following statement to ABCNews.com which they had also posted on the change. org website

“Total Health Care has NOT DENIED OR DELAYED TREATMENT,” it said. “Because this is a public venue, we are not able to discuss specifics regarding personal health information, as this would violate privacy rights … Our goal is to continue to deliver on our promise of being ‘Totally There’ for our members.”

Click here for the full statement, which she posted on Oberg’s Change.org petition.

"It's ridiculous that she responds like this while not even providing my mom an opportunity to sign a medical release form so that she CAN discuss it!” John Oberg wrote in an email to ABCNews.com.

Alexander later told ABCNews.com, “There is no reason why Karen’s chemotherapy cannot be continued at the University of Michigan from our perspective at Total Health Care,” but added that this is only if Karen Oberg is authorized by Total Health Care for the treatment.

John Oberg said he hasn't received a notice yet from Total Health Care authorizing his mother's care are in the University of Michigan Health System. The hospital says hasn’t received the authorization either, although it told him it has repeatedly submitted paperwork to the insurance for that authorization, he said.

John Oberg said he plans to file a complaint with the Michigan Department of Insurance and Financial Services.

“Something is not being communicated effectively here,” said Renee Campbell, a manager of the insurance unit of that department, who learned of the Obergs' case from ABCNews.com.

Campbell said the Obergs have a few options for dealing with the coverage dispute, and her office regularly facilitates communication between insurance providers, patients and hospitals.

Patients can appeal insurance coverage decisions, and many states have offices set up to help patients facilitate these conversations with their insurers and providers, said Cheryl Fish-Parcham, the deputy director of health policy at Families USA, a national consumer protection nonprofit.

Find more information on your state insurance help resources here.

Since Karen Oberg has Total Health Care through Medicaid, she actually has two options in Michigan, Campbell, a manager of the insurance unit with the state’s office of consumer services: she can file an appeal through the state’s Medicaid ombudsman or through her unit within the Department of Insurance and Financial Services. There’s even a special form to expedite the process if the person needs covered care urgently, she said.

“This is something that our office deals with on a daily basis with consumers,” Campbell said. “Sometimes, just putting something in writing and getting it to our office is sometimes enough to get things moving.”

  • 1
  • |
  • 2
Join the Discussion
blog comments powered by Disqus
You Might Also Like...