Insurance issues may put Groton teacher’s kidney transplant on hold
|By Joe Wojtas, The Day, New London, Conn.|
|McClatchy-Tribune Information Services|
But now he may have to delay that surgery and face the prospect of going on dialysis after his insurance company told him last week he is not fully covered for the procedure because the hospital is not in his insurance network. This means he could face a bill of as much as
The news came as a shock to Vernet and his wife Katy, who say the hospital told them last summer the transplant would be fully covered.
"I was in total disbelief, " Vernet said today about the call he received from
"I've got this overwhelming joy and gratitude associated with finding a donor and then it's just pulled out from under you," he said.
Vernet, who is slated to go to
Delaying the transplant may now put him in the position of having to go on dialysis, as his kidney function has dropped to just 8 percent.
Vernet has taken a leave from work to preserve his kidney function as long as possible and hopefully avoid going on dialysis before surgery. The long days in the classroom left him exhausted and put more stress on his kidney.
Vernet said he does not think he can go ahead and incur the out-of-pocket costs, especially with his two children approaching college age.
If he did proceed, he would have to agree to pay whatever the out-of-pocket costs would be. The bill could escalate beyond the
The Vernets, who live in
"If they had said 'you're out of network,' we would have went to the
She said the hospital and insurance company are blaming each other for the problem and the hospital has filed a grievance with Anthem.
"We really don't know who dropped the ball," she said. "Everything had been put in place but now were in complete limbo. No one is calling us back."
The Vernets have contacted both the hospital and insurance company about the coverage, but so far, there has been no resolution. They have also contacted U.S. Sen.
Vernet's search for kidney drew widespread attention as his friends and family used
Brigham and Women's spokeswoman
Both the hospital and Anthem took steps late this afternoon to secure that permission and said they could discuss the situation once they did.
For Vernet, who teaches science at
"This is strange, because you realize how much of a business this is," he said.
(c)2014 The Day (New London, Conn.)
Visit The Day (New London, Conn.) at www.theday.com
Distributed by MCT Information Services