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UpInArms

(52,276 posts)
Thu Dec 12, 2024, 09:24 AM Dec 2024

Insurance company denies covering cost of life-saving medicine for metro woman

Source: Fox4KC

KANSAS CITY, Mo. — Blue Cross and Blue Shield of Kansas City denied covering the cost of one metro woman’s medicine that she says could save her life, leaving her with an over $8,000 monthly bill.

“I was at risk for spontaneous internal bleeding that could kill me,” Kaitlyn Sy said.

Sy, a KU Medical student, said she’s fighting back just weeks after a near death experience.

… snip …

Just weeks ago, this scenario played itself out, Sy was forced to go to the ER to treat internal bleeding. Her hematologist had one more option, a pill called ‘Promacta,’ that could stabilize this issue. Things changed when Sy got to the pharmacy.

“The pharmacy tech – her eyebrows go up – and I said this can’t be good and she says this medication is going to cost you over $8,000,” Sy said.

Sy said she can’t afford to pay the bill every month. She called her insurance company, and they stood by the denial.

Read more: https://fox4kc.com/news/insurance-company-denies-covering-cost-of-life-saving-medicine-for-metro-woman/

39 replies = new reply since forum marked as read
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Insurance company denies covering cost of life-saving medicine for metro woman (Original Post) UpInArms Dec 2024 OP
multiply this by millions of individuals and its easy to see how people might be... miffed at the sytem. Blues Heron Dec 2024 #1
But but but murder is bad. onecaliberal Dec 2024 #22
Rake in as much CASH as possible until their "customer" really get's sick Bengus81 Dec 2024 #2
"Rake in as much CASH as possible" speak easy Dec 2024 #27
How is denying life-saving care simply to increase profits... GiqueCee Dec 2024 #3
There is no explanation for it ReRe Dec 2024 #4
Is there a RICO somewhere in this ? BattleRow Dec 2024 #5
Interesting question. summer_in_TX Dec 2024 #7
They classify it as good for their investors IronLionZion Dec 2024 #8
The phrase I hate most in the world is... GiqueCee Dec 2024 #19
A start is to reclassify WalkerinSC Dec 2024 #25
Trump and the GOP congress want to do the opposite IronLionZion Dec 2024 #30
Privatization... GiqueCee Dec 2024 #31
And more people will die from treatable causes than ever before! ShazzieB Dec 2024 #37
Other countries also regulate the cost of drugs TexasBushwhacker Dec 2024 #35
For government, it's the taxpayers, citizens, and anyone else using the programs IronLionZion Dec 2024 #29
Are their stockholders ever denied coverage? BattleRow Dec 2024 #33
Because rich people make the rules Bettie Dec 2024 #24
'gotta protect shareholder value' but never admit they ARE the primary shareholders Attilatheblond Dec 2024 #36
Medicare rx plan cover this drug. idahoblue Dec 2024 #6
Insurance companies are parasites. Tm - Luigi. nt TBF Dec 2024 #9
And Pharma is guilty of extortion Seinan Sensei Dec 2024 #16
Sure - plenty of guilt to go around. Pharma cos. will do their best TBF Dec 2024 #20
Most pharmaceutical breakthroughs Bettie Dec 2024 #26
Reaping profits from the work done by others... GiqueCee Dec 2024 #34
What is a "Metro Woman" ? Do you mean as opposed to a "Rural" Woman? msfiddlestix Dec 2024 #10
It is a term used UpInArms Dec 2024 #18
Thank you. I wondered if it, the term, was specifically related to that specific location. msfiddlestix Dec 2024 #38
A city's metro area covers suburbs across state lines IronLionZion Dec 2024 #32
It seems that the leadership of that company is also in hiding.... xocetaceans Dec 2024 #11
The death panel can run but they can't hide. C0RI0LANUS Dec 2024 #15
Interesting... GiqueCee Dec 2024 #21
and this time: blue cross blue shield, ok about killing their "members" one "member" at a time orleans Dec 2024 #12
Pharmaceutical companies are just as bad. Charging extreme amounts for life saving medications. Fla Dem Dec 2024 #13
If this woman dies Farmer-Rick Dec 2024 #14
The real problem is prescription drug pricing. Jacson6 Dec 2024 #17
The real question is how much does it cost to make ? Nigrum Cattus Dec 2024 #23
Novartis offers a patient assistance program for this drug. Sibelius Fan Dec 2024 #28
Kick ck4829 Jan 20 #39

Blues Heron

(6,549 posts)
1. multiply this by millions of individuals and its easy to see how people might be... miffed at the sytem.
Thu Dec 12, 2024, 09:27 AM
Dec 2024

Bengus81

(8,283 posts)
2. Rake in as much CASH as possible until their "customer" really get's sick
Thu Dec 12, 2024, 09:38 AM
Dec 2024

Then tell em to fuck off,we're denying this drug that could save your life. They don't care,they made thousands off of this person and now they are not about to lose it over an expensive drug.

BTW,these drug companies couldn't give a rats ass about the high price of drugs. It just gives them an excuse to deny coverage on the sickest people.

speak easy

(11,267 posts)
27. "Rake in as much CASH as possible"
Thu Dec 12, 2024, 11:57 AM
Dec 2024

That cuts two ways: The real issue across the board is price gouging by big pharma.

GiqueCee

(1,906 posts)
3. How is denying life-saving care simply to increase profits...
Thu Dec 12, 2024, 09:45 AM
Dec 2024

... NOT classified as homicide? Premeditation, malicious intent, and ruthless execution are documented daily by greedy psychopaths, and they are paid bonuses.
Explain it to me like I'm 5.

ReRe

(11,353 posts)
4. There is no explanation for it
Thu Dec 12, 2024, 10:06 AM
Dec 2024

and if they were honest, they would have to say "...but Greed is Good."

I think they read it as "Greed is God."

IronLionZion

(48,013 posts)
8. They classify it as good for their investors
Thu Dec 12, 2024, 10:57 AM
Dec 2024

human sacrifices must be made so rich people can get richer.

GiqueCee

(1,906 posts)
19. The phrase I hate most in the world is...
Thu Dec 12, 2024, 11:36 AM
Dec 2024

... "Our first obligation is to our stockholders." To which I reply, your first obligation should be to act as a decent human being, a task at which you have, thus far, failed miserably.
The proverbial substance is about to hit your fan with a resounding splat. As they say, FAFO, motherfuckers.

WalkerinSC

(275 posts)
25. A start is to reclassify
Thu Dec 12, 2024, 11:56 AM
Dec 2024

by statue that all insurance 'providers' are classified as non profit entities and delist from stock market. Remove all denial authority from them. They are merely the vessel to pass through payments. Allow them to set up small boutique for profit entities for private insurance that they have full control over but cannot be taken full public. Open up Medicare/Medicaid with some restrictions to make it competitive. Basically create something akin to the German system. Multi-payer with competition. It's also time to put some of our resources to use for the people of this country. I am not a fan of nationalization per se, but there is oil, timber, and other resources on federal land that can be monetized in a wise manner to create a sovereign wealth fund to pay for the citizens of this country to have a way to pay for healthcare.

IronLionZion

(48,013 posts)
30. Trump and the GOP congress want to do the opposite
Thu Dec 12, 2024, 01:51 PM
Dec 2024

and privatize Medicare/Medicaid and everything else so executives can get wealthy from death.

GiqueCee

(1,906 posts)
31. Privatization...
Thu Dec 12, 2024, 03:21 PM
Dec 2024

... benefits no one but the Wall Street Weasels that told their pet Republicans to shove it down our throats, whether we like it or not, just like Trump's promise to "protect women, whether they like it or not."
So the burning question is, how much of this evil treachery will we tolerate before shit gets real. If we let these traitors get too far down this path, there may be no turning it around.
If Garland had grown a pair when it really mattered, we wouldn't be in this mess, and the Orange shitstain would be in prison where he belongs, but nooo... Maybe his right leg is shorter than the other one, because right seems to be direction he leans when the winds of change start to blow.

ShazzieB

(19,715 posts)
37. And more people will die from treatable causes than ever before!
Thu Dec 12, 2024, 07:41 PM
Dec 2024

But that is naturally of no concern to those ghouls.

TexasBushwhacker

(20,856 posts)
35. Other countries also regulate the cost of drugs
Thu Dec 12, 2024, 07:06 PM
Dec 2024

With everyone else on the planet regulating drug prices, drug manufacturers get all their profits in the US.

IronLionZion

(48,013 posts)
29. For government, it's the taxpayers, citizens, and anyone else using the programs
Thu Dec 12, 2024, 12:18 PM
Dec 2024

no stockholders to demand more profits. It's a direct conflict when health insurance companies have a profit motive for people to die faster.

Bettie

(17,925 posts)
24. Because rich people make the rules
Thu Dec 12, 2024, 11:55 AM
Dec 2024

and they hide behind "shareholder value is the most important thing in the world" to justify it.

Attilatheblond

(5,382 posts)
36. 'gotta protect shareholder value' but never admit they ARE the primary shareholders
Thu Dec 12, 2024, 07:19 PM
Dec 2024

IOW, screw the women & children and LET ME INTO THE LIFEBOAT!

idahoblue

(415 posts)
6. Medicare rx plan cover this drug.
Thu Dec 12, 2024, 10:45 AM
Dec 2024

You just have to live long enough to qualify.
MEDICARE FOR ALL!

Seinan Sensei

(886 posts)
16. And Pharma is guilty of extortion
Thu Dec 12, 2024, 11:27 AM
Dec 2024

… in the name of Research/Development

And I’ll betcha there’s Fed money (and a university’s research) baked into that high-dollar pill

TBF

(35,055 posts)
20. Sure - plenty of guilt to go around. Pharma cos. will do their best
Thu Dec 12, 2024, 11:40 AM
Dec 2024

to kill the Kennedy nomination. It will be entertaining to watch.

Bettie

(17,925 posts)
26. Most pharmaceutical breakthroughs
Thu Dec 12, 2024, 11:56 AM
Dec 2024

come from government funded university research.

They usually reap the profits from research done by others and paid for by others.

GiqueCee

(1,906 posts)
34. Reaping profits from the work done by others...
Thu Dec 12, 2024, 04:59 PM
Dec 2024

... defines Elon Musk's business model. That motherfucker is poised to do incomprehensible damage if he's not reined in somehow.

msfiddlestix

(8,009 posts)
38. Thank you. I wondered if it, the term, was specifically related to that specific location.
Thu Dec 12, 2024, 09:52 PM
Dec 2024

I never hear that usage in any context relating to people in the Bay Area.
I was beginning to wonder if "Metro" was now a new reference term for Women or People in any city around the country. thank you .

IronLionZion

(48,013 posts)
32. A city's metro area covers suburbs across state lines
Thu Dec 12, 2024, 03:30 PM
Dec 2024

so for Kansas City, it includes areas of Missouri and Kansas.

xocetaceans

(4,041 posts)
11. It seems that the leadership of that company is also in hiding....
Thu Dec 12, 2024, 11:13 AM
Dec 2024
https://www.bluekc.com/consumer/blue-kc/leadership/

and possibly that they don't think that Google works....

https://www.bluekc.com/static/consumer/blue-kc/leadership.html

They still even have PDFs on their backgrounds up. It is insanely poor security for a group whose "business model" objectively acts to the detriment of the general public. Maybe, they actually think that they are "respectable business people" instead of what they actually are? Who knows?

orleans

(35,737 posts)
12. and this time: blue cross blue shield, ok about killing their "members" one "member" at a time
Thu Dec 12, 2024, 11:16 AM
Dec 2024

and $8,000 a month?
wtf?


Novartis Pharmaceuticals Corporation manufactures Promacta (eltrombopag).
GlaxoSmithKline (GSK) and Ligand Pharmaceuticals discovered eltrombopag through a research collaboration. Ligand sold its Promacta assets and royalty to Royalty Pharma for $827 million.

-google search ("AI overview)

Fla Dem

(26,342 posts)
13. Pharmaceutical companies are just as bad. Charging extreme amounts for life saving medications.
Thu Dec 12, 2024, 11:20 AM
Dec 2024

I understand there are enormous expenses that go into the research and development of drugs. But many of these companies make enormous profits and pay their top executives enormous salaries.

Farmer-Rick

(11,692 posts)
14. If this woman dies
Thu Dec 12, 2024, 11:22 AM
Dec 2024

We can trace the death back to Blue Cross and Blue Shield of Kansas City. We can then follow the chain of blame from the nurse who reviewed the claim to the doctor hired to rubber stamp those decisions. Then to division supervisors and department heads to the top of food chain President and Chief Executive Officer of Blue KC, for authorizing this policy. Her name is easily obtainable. She needs to be held to account.

I think these CEOs hide behind their deadly organizations. Trying to pretend they don't murder people for a living. They hope we will blame the $30,000 a year Blue KC nurse or the $160,000 a year Blue KC doctor. But really at the top are the people who really pull the levers of death. The $24 million a year CEO is really the one who would be responsible for the girls death. She makes $24 million a year and can't spare $8,000 to keep a person alive.

Jacson6

(1,077 posts)
17. The real problem is prescription drug pricing.
Thu Dec 12, 2024, 11:32 AM
Dec 2024

Unless Congress creates regulations to rein in pharma this will be a continuing problem.

Nigrum Cattus

(432 posts)
23. The real question is how much does it cost to make ?
Thu Dec 12, 2024, 11:55 AM
Dec 2024

It might only cost a $100 or less to make. They know it's a
drug someone would need & so they stick it to em.

Sibelius Fan

(24,663 posts)
28. Novartis offers a patient assistance program for this drug.
Thu Dec 12, 2024, 12:15 PM
Dec 2024

I have been on Cosentyx for over a decade. List cost is over $7000 a month. My cost thru the Novartis Patient Assistance Program is $0. It’s based on financial need. In my case, that means having a yearly income under $103,000 for a 3-person household. I imagine their program for Promacta is similar.

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