A Dying Man Was Nearly Denied Health Care Coverage Over A 26-Cent Payment

SergioGoFundMeSergio Branco, 33, nearly missed out on a life-saving cancer treatment due to a billing error.

20-six cents nearly blocked an Edison, N.J. man from receiving a life-saving bone marrow transplant.

Sergio Branco, 33, was diagnosed with Acute Myelogenous Leukemia (AML), an aggressive cancer that attacks the blood and bone marrow, in early 2013.

But without a bone marrow donor, Branco’s only option was a long course of chemotherapy treatments, which would put him out of work for five months. He was allotted three months of leave under the Family Medical Leave Act, but when the time was up, his employer, waste management company Russell Reid, fired him from his job as a truck driver, his family told The Star Ledger’s Karin Price Mueller.

Around the same time, Branco got word from his doctors that they had found a bone marrow match. He was scheduled for a transplant on August 16. The price tag: $US500,000.

Without a job for insurance, Branco and his wife, Mara, decided to enroll in COBRA, which gives terminated workers a chance to continue their existing health coverage so long as they pick up the full tab. They also launched a GoFundMe fundraising page to help meet their household costs while he recovered.

And that’s where things went wrong. Per Mueller:

“The cost [of COBRA] would be $US518.26 per month. So on or about May 24, Mara Branco filled out the paperwork and mailed a check to Paychex for the first month of coverage. She wrote the check, dated May 24, for an even $US518, inadvertently missing the 26 cents … The family thought all was well, and Branco continued to receive treatment. But later in June, the hospital told Branco he didn’t have insurance coverage.”

Things only got messier from there. The “middle man” handling his benefits transfer from his former employer and COBRA, Paychex, claimed the Brancos hadn’t fulfilled their payment, Mueller reports. The Brancos went back and forth between his former employer’s human resources manager and Paychex for months with no resolution.

“Paychex is working diligently with our client and other appropriate parties right now to reinstate Mr. Branco’s coverage,” a spokeswoman said. “We are very ardently working on the situation with all parties including the carrier, and the decision ultimately rests with the carrier.”

The Brancos hired a lawyer, intent on suing. Thankfully, they didn’t have to bother with the legal headache.

The Department of Labour called on Friday to tell the Brancos his former employer would reinstate his coverage.

“They said the company did it wrong. I am super happy,” Mara Branco told Mueller. “It’s like a weight has lifted off my shoulder.”

Happy ending aside, Branco’s case only highlights the tangled web that is America’s employer-provided health care model.

“When Americans are asked about their top concerns related to health insurance, they consistently say that they’re most worried about losing their coverage,” notes Think Progress’ Tara Culp-Ressler. “Many Americans remain in jobs longer than they would have otherwise liked to because they’re afraid of losing their health care — and American seniors are increasingly putting off retirement for that reason, too.”

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