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Lakewood woman says husband can't leave the hospital because insurance won't cover breathing machine

Posted at 6:19 PM, Sep 22, 2020
and last updated 2020-09-22 20:42:43-04

ENGLEWOOD, Colo. – A Lakewood woman is desperate to bring her husband home from the hospital, but says her insurance company is denying the doctors the ability to release him.

Charlene Lowe says her husband Gerald has congestive heart failure. He went into the hospital in late August and is still there.

“My husband was admitted to the hospital Aug 24 through the emergency room to intensive care. He was on life support for five days and remains in the hospital today,” Lowe said. “He was having a difficult time breathing.”

She says doctors tried different therapies such as a BiPAP breathing machine, but it didn’t work. Two pulmonologists, a nurse and his current doctor are recommending he go home with an AVAPS-AE device, an auto-titration mode of noninvasive ventilation designed for the home environment.

“The doctor attending him now has also called the insurance company to tell them that he needs this machine, and he will not release him without this machine, because to do so is to sign his death warrant,” Lowe said.

Lowe says doctors have done everything her insurance company, United Healthcare, has asked for. Including a peer-to-peer conversation.

Her benefits claim to cover mechanical equipment for respiratory failure, but she has been denied coverage for the breathing machine time and time again.

“I'm furious. It’s there in black and white, and it says it’s a covered benefit,” Lowe said.

Every day Gerald remains in the hospital adds to the already $40,000 in medical bills they have acquired.

“I became sick due to the stress. I have a senior in high school who’s having a hard time concentrating with COVID, and me coming to the hospital every day,” Lowe said.

She says Gerald was a police officer and EMT for 20 years and served his community.

The couple married last year. She just wants to go back to being newlyweds instead of worrying about the cost of care.

“I don’t know the full answer, but I know this isn’t it. We shouldn’t have to pay and pay and go into debt and still not get what we need,” she said.

United Healthcare says members have the right to appeal their decision. We have questions about their denial and are waiting to hear back.