Grandfather's $92K Surgery Bill Resolved After Health Insurance Mix-Up

Unexpected Heart Surgery and Bill

• 🩺 A 61-year-old HVAC contractor from Staten Island experienced shortness of breath and discovered a heart blockage.
• 💡 He underwent a life-saving surgery to have a stent placed, which was successful.
• 💸 Following the surgery, he received a bill for $92,000, which caused him significant distress.

Insurance Policy Conflict

• 🏥 Peter had both private health insurance and supplemental Medicare coverage.
• 🔄 His private insurer initially paid the hospital but later reversed the payment, claiming they were not the primary payer.
• 🏓 The secondary insurer then refused to pay, stating they were also not the primary payer, leaving Peter stuck between both policies.
• 📉 This insurance dispute led to his appeals being denied and forced him to retire while fighting the claim.

"7 On Your Side" Intervention

• 📢 Peter, having seen the results "7 On Your Side" achieved for others, reached out for assistance.
• 🤝 The news team contacted both of Peter's insurance plans.
• ⚡ Within 24 hours, the primary insurer, Etna, stepped up and agreed to cover the majority of the surgery bill.
• ✅ His secondary insurer, Emblem, covered the remaining balance, resolving the $92,000 patient portion of the bill.

Resolution and Relief

• 🙏 Peter described the resolution as a "miracle of God" and expressed immense relief from the anxiety he had experienced for a year.
• 💬 Both Etna and Emblem stated they were proud to partner with "7 On Your Side" and committed to accurate member coverage, happy to work towards a smooth resolution.