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Updated: Tuesday, 27 Jan 2009, 6:25 PM EST
Published : Tuesday, 27 Jan 2009, 4:20 PM EST
Middletown (WTNH) - Imagine battling cancer and at the same time fighting the insurance company about your course of treatment. It can happen to any one of us. And for one Middletown resident it did. But she found out that her lifeline was only a phone call away.
A hot, hearty soup on a cold winter day has cancer patient Sharon Hines happily cooking in the kitchen. Hines, a non-smoker, has lung cancer. But that has not been her only challenge.
"I was totally stressed out by this," Hines said.
She is stressed out because her insurance had twice denied an FDA approved therapy which her doctors had prescribed.
"The insurance company felt that the Avastin was not appropriate
in my situation because I had taken this other therapy first,"
Hines said.
But as a nurse who specializes in cancer care, Hines knew it
was the right course of treatment.
"Avastin can actually prolong your survival, it also can delay the time to progression of your disease," she said.
Approval finally came after Hines called the State Office of the Health Care Advocate.
"Don't accept the insurance companies' word as final," Kevin Lembo, Connecticut Health Care Advocate, said.
Lembo is Connecticut's Health Care Advocate. "When you are facing cancer, or cardiac illness or diabetes or other life threatening diseases, you need as many people on your corner as you can get because you need to focus on being the patient, getting well," he said.
Last year, Hines was among the more than 2,000 cases the office handled.
"Connecticut is very lucky as well in that it's one of a few states that has an independent office like this," Lembo said. It "doesn't work for the insurance industry, doesn't work for the insurance commissioner and is really there to work for the consumer."
"I understand, now that I have been through the process, that you want to call them sooner rather than later," Hines said.
It saved Hines $100,000 -- the cost of the drug she would have paid out of pocket if the health care advocate office had not intervened.
Last year, the office of the Health Care Advocate saved consumers $5 million in costs.
The
Health Care
Advocate has a toll free number -- 866-466-4446.
Hines also has a
website for more information.
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