Spokane woman feared death when insurance company denied coverage of her lifesaving medication
SPOKANE, Wash. – — A Spokane woman says she’s being forced to leave the state just to get the Medicare she needs.
Roberta Wesner’s art room was where she dreamed about spending her retirement; giving paint lessons. Right now, she can’t leave her bed.
“I’ve been very afraid that my blood pressure would drop so low that I would pass away,” she explained.
Roberta suffers from a crippling low blood pressure condition that makes getting out of bed a challenge and there’s only one drug that allows her to be active.
“Northera is lifesaving for me,” said Wesner.
In October when she made the switch from private insurance to Medicare, Northera coverage was priority number one. She did her research and found it was covered by Humana’s Medicare supplement. She, her husband and her insurance agent all called the company to confirm and she felt reassured.
“We all heard them say ‘yes its covered’ on this basic plan,” she said.
When she went to get the prescription filled, she learned otherwise. Northera was not covered. If she wanted it, she was told she’d either have to shell out thousands of dollars or get half the dose the doctor ordered each month. When she tried to get out of her new plan, she says the company and Medicare wouldn’t allow a switch until another enrollment period.
“You don’t qualify, they told us. You either have to be in a nursing home, a care facility or you have to move.”
So she’s moving.
Away from her husband and home of 32 years.
“It’s really sad that I have to beat the system that way but if that’s what it takes to get me out of this situation so I can get my drugs covered, that’s what I have to do,” said Roberta.
This situation has taught her a lot, especially to never stop fighting for herself.
“Before I felt hopeless and I was very depressed. Now I feel like finally, I’ll be able to get my medication and I’ll be able to get back to my life again,” said Roberta.
Roberta will be moving in with her daughter and grandkids. She says it’s just temporary and she’s looking forward to it; there’s a new grandchild she hasn’t been able to see because of her condition these last few months.
As for the company she says is forcing her to take such desperate measures, when we reached out to them for comment they said:
“Protecting our health plan members’ privacy is an important priority for Humana, and federal privacy regulations restrict what information Humana can share about individuals and their medical care/plans. We always work diligently to resolve our members’ issues.”
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