Mother has cancer: when the insurance refuse to pay

News 18 December, 2017
    Clarisse Baruch, a mother of two young children, suffering from cancer of the breast, lives in uncertainty due to an insurance issue.

    Nadia Lemieux

    Monday, 18 December 2017 00:00

    Monday, 18 December 2017 00:00

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    Reached of a cancer of the breast, a Montreal-based mother of two young children, lives in uncertainty, stuck between the Régie de l’assurance maladie du Québec (RAMQ) and private health insurance of his spouse who refuse to cover his treatments.

    At the end of the month of October, MEDICARE has agreed to reimburse the expenses of the treatment of hormone therapy of Clarisse Baruch on the first 21 days, which amounted to 9400 $. Shortly after, she received a letter from the Régie informing him that it had to pay this amount before 30 days, since it was in fact covered by the private insurance of her husband.

    However, the insurer refuses coverage because Prosperous Baruch works less than 30 hours per week.

    It all started after the birth of the second son of Mrs. Baruch, Ezekiel. She had difficulty breastfeeding and had noticed a mass at the level of her left breast. “At the beginning, I told myself that it was due to breastfeeding “, she says. Last may, she decided to consult her doctor, who taught him that it was a cancer of the breast.

    After five months of chemotherapy, the situation worsens. The cancer has spread to the right breast, the bone, and possibly to the liver. He prescribed the hormone therapy, a treatment that is expensive, that is designed to block the production of hormones. It is this treatment that is not covered by the RAMQ.

    In this impasse, Ms. Baruch had to stop his treatment for nearly three weeks.

    “I think it’s unfair because it works and it has a portion of the salary is deducted for insurance, and at the time, it causes problem. This is not honest on their part”, laments Ms. Baruch.

    Program Pfizer

    In the urgency to provide him with his medication, the time that the conflict with the insurance companies rule, his doctor made an agreement with the program, Pfizer and a pharmacy. However, it will eventually have to repay all or part of the cost of treatment.

    This agreement is only 21 days for the moment. At maturity, Ms. Baruch is not known whether it has other medications.

    Collection of donations

    Ms. Baruch is followed by two accompanying perinatal period since her last birth, but the period of cover comes to an end this week. In addition, his spouse is currently working in the Abitibi-Témiscamingue region.

    For the sake of not leave it without help, its companions have decided to create a fundraiser online.

    “It’s been a long time that it has stopped working and his spouse, he is trying, but they don’t have a big income. To see that the family must survive with almost nothing, that we annoyed a lot,” emphasizes the accompanying Ophelia Clermont.

    The 30-day period allocated by the RAMQ now over, the campaign aims to repay the 9400 $.