15-Month-Old Gavin Denied Care By His Insurer Pacific Source

Main Category: Health Insurance / Medical Insurance
Article Date: 06 Sep 2008 - 6:00 PDT

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"My 15-month-old son Gavin was recently denied by Pacific Source insurance in Oregon due to the fact that he has recently gotten ear tubes - of all things," Nixie Krusee of Portland, Ore., writes.

"He has been fighting ear infections for the past eight months and by doctor's recommendations he had ear tubes placed in both ears. His ears are now fine, no more endless up-all-nighters, chronic pain, and antibiotics every three weeks. Everything has completely cleared up - except he was denied health insurance now because of his tubes. I thought this procedure was very common?

"They explained in my denial letter that he 'had a potential for significant future medical expenses that is outside their acceptable criteria.' I assumed tubes in his ears would be the cheaper option to save them the cost of all the doctor visits, antibiotics, and future hearing damage if he didn't get his ears fixed."

After five months, the family found one policy - an extremely expensive one - to cover little Gavin, but only after searching and arguing and only separate from their own family plan.

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Eighty-two percent of Americans think the U.S. healthcare system should be fundamentally changed or completely rebuilt (Commonwealth Fund, Aug. 7, 2008). America's nurses know that only single- payer, improved and expanded Medicare for all will fix our broken system and the tragedy of our devastated families. HR 676, by U.S. Rep John Conyers, is the most comprehensive, cost effective way to achieve guaranteed healthcare for all.

http://www.GuranteedHealthcare.org

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