Unexpected illnesses have family on financial ropes

A few years ago, Peony Hammerquist was satisfied with her family’s health care coverage.

That was before her husband suffered an unusual brain infection that left him permanently disabled and unable to continue working as a corporate accountant.

It was before her 19-year-old daughter took out her own health insurance only to have the insurance company cancel her coverage when doctors found she had thyroid cancer.

“There’s a lot of things that need to be fixed,” Peony Hammerquist said. “You can’t live with health insurance, you can’t live without it.”

For her family, everything changed in September 2007. Before that, her husband, Don, had always been healthy.

Then one night, Don began having seizures. A sinus infection had traveled to his brain, and he slipped into a coma.

“They basically didn’t think he was going to live,” Peony said. “They told everybody, ‘Say goodbye.’”

After two months in the hospital, Don spent another six months relearning to walk, talk, and do “everything we take for granted,” Peony said. It could take five to seven years before they know what brain damage is permanent and what is temporary.

Don Hammerquist had insurance through his job. When he became ill and was unable to return to work, he was covered by COBRA insurance for 18 months — “which is atrocious, $1,000 a month just so he could stay insured,” his wife said. “Nobody would insure him at that point.”

Under the Consolidated Omnibus Budget Reconciliation Act – often referred to as COBRA — people who lose their health benefits can continue group health benefits for limited periods of time. Qualified individuals may be required to pay the entire premium for coverage, up to 102 percent of the cost.

Meanwhile, their daughter, Sara Hammerquist, unsure whether she wanted to attend college, took out her own health insurance policy, since state law no longer allowed her to be covered under her parents’ policy.

In fall 2008, Sara was in a car accident. As doctors were checking her for internal injuries, they found a lump in her throat and mentioned that she might want to have it checked.

When Sara went to the doctor for other reasons a few months later, the lump had grown. Doctors determined it was thyroid cancer, and Sara underwent two surgeries. Her cancer is currently in remission.

Meanwhile, her insurance company dropped her, rescinding coverage back to the day she took out the policy. The company claimed her cancer was a pre-existing condition that Sara must have known about.

Sara works two jobs to pay off her medical bills. She lives at home with her parents or stays with her sister in Rapid City because she can’t afford to pay rent.

The family has hired an attorney to try to get her insurance reinstated. Rates would likely be higher, though, and the insurance company is pushing to have Sarah pay more than a year’s worth of back premiums.

Attorney bills likely will amount to thousands. “But without that attorney … we wouldn’t even have a chance,” Peony said. Insurance companies “won’t listen to people like us.”

Luckily, she said, she was hired by the Spearfish School District as a teacher’s aide just as her husband’s COBRA policy was about to run out. He is now covered through her school insurance.

“I basically work for the insurance, because it’s so high,” she said. “When everything you make goes to insurance and medical bills, it’s kind of tough.”

For families like the Hammerquists, the new health care reform law could prove to be a blessing. The law’s provisions could also prevent others from finding themselves in a similar situation. Sara would have been able to stay on her parents’ insurance longer, despite the fact that she wasn’t going to school. The new law also prevents insurance companies from rescinding coverage if the policyholder has paid all premiums.

“I think it is definitely a start,” Peony said. “I think insurance companies have way too much power to just, you know, do what they want to do. You pay this insurance, but as soon as something bad happens, they want to drop you.”

Contact Heidi Bell Gease at 394-8419 or heidi.bell@rapidcityjournal.com