Empowered Insight: A Personal Cancer Journey
TL/DR –
Minnesota Senate member, Kari Dziedzic, shares her personal experience with ovarian cancer and the difficulties of navigating medical insurance coverage for treatments and necessary equipment. She reveals issues such as high treatment costs, denied coverage for essential equipment, and inflexible policies that put patients in difficult positions. Dziedzic emphasizes the need for healthcare policy reform, including standardized prior authorization rules, Medicare coverage revisions, and legislation for broader coverage to increase quality of life for all patients.
Personal Journey through Health & Human Services Policy
Throughout my tenure in the Minnesota Senate, I seldom immersed myself in health and human services policy until my diagnosis with ovarian cancer in winter 2023. Despite continuing my duties as the elected Senate majority leader, my diagnosis propelled me into understanding the complexities of health care, medical access, and insurance coverage.
Enduring the rigorous treatment for ovarian cancer, involving countless medical appointments, surgeries, chemotherapy and radiation, I balanced my Senate work and treatment. After receiving a shocking bill of $6,000 for genetic testing, despite preauthorization, I discovered that these tests are covered if deemed medically necessary. Thankfully, I had the understanding to appeal these charges.
Later, a resounding bill of $100,000 for chemotherapy treatments brought to light the lack of preauthorization for the subsequent two treatments. This led to a convoluted process of coordinating between care providers to appeal and rectify the oversight.
In the 2024 legislative session, we commenced changes in prior authorization rules to standardize timeline reviews, expeditions, appeals, and continuity of care. Provisions were also made to ensure chronic conditions retain prior authorization unless treatment standards are adjusted.
When my cancer metastasized to my spine in January 2024, impacting my mobility, I found that many transitional care facilities do not accept patients undergoing treatments due to federal policies, forcing patients into choosing between treatment or transitional care. Furthermore, navigating insurance for necessary equipment like wheelchairs was challenging.
Essential products like shower chairs that enhance quality of life for patients aren’t considered Durable Medical Equipment (DME) and therefore not covered by insurance. This year we passed a bill requiring coverage for wigs for cancer patients. But, broader Medicare coverage is needed for DME to improve quality of life.
As I continue with therapy, I’ve received specialized braces, which aren’t always covered due to complicated Medicare rules. I am discussing these challenges with our congressional delegation, urging them to take action.
Interactions with caregivers have opened my eyes to disparities beyond my experiences. High drug costs, even when covered by insurance, can be a burden for patients. Similarly, monopolies in wheelchair companies can lead to significant repair delays.
The past two years have been humbling and introspective. I feel fortunate to have the resources and time to navigate my medical challenges. I want to express my gratitude to my family, friends, constituents and caregivers for their support. Advocating for an easier access to quality care and equipment for all Minnesotans has become my mission.
—
Read More Health & Wellness News ; US News