Life-saving care suddenly cut out of Groton-native's insurance p - WFSB 3 Connecticut


Life-saving care suddenly cut out of Groton-native's insurance plan

Posted: Updated:
Gretchen Chipperini told the I-Team that she was forced to move out of Connecticut when Anthem dropped her life-saving care. (WFSB photo) Gretchen Chipperini told the I-Team that she was forced to move out of Connecticut when Anthem dropped her life-saving care. (WFSB photo)

The I-Team started digging when a Groton native said doctors who provide her with life-saving care were suddenly cut out of her insurance plan.

Gretchen Chipperini said she had no choice but to move out of state to keep getting the treatment.

It's something that I-Team learned may happen to more people soon.

Chipperini said she was born with two rare syndromes, so she's not the typical health insurance customer.

"I am a complex medical patient, yes, but I can't help that," she said. "I wish I wasn't."

She said there are only a few doctors in the country equipped to treat her. One is in Boston.

She said she needs that care to stay alive, so she's always pays close attention to her policy.

"I had the same insurer, Anthem, before for many years and they became one of the many insurance providers when Obamacare began, and I stayed with one of their gold [Preferred Provider Organization] plans with them," Chipperini said.

Earlier this year, she said she found out there had been a change in her policy.

She met Anthem and representatives told her the network had changed.

"'We're still calling them PPO plans, but anything out of state except for the contiguous counties to CT are considered out of network,'" Chipperini cited.

That meant her Boston medical team was now an out-of-pocket expense. It was something she simply could not afford.

She said she tried to find a doctor in Connecticut.

So I thought I'd go there and speak with one, he said to me "amazing, you're one of the first people with your syndrome I've seen in my entire career."

Desperate to keep her team of experts in Boston, she had a meeting with Anthem.

When that didn't help, she called the attorney general, the insurance commissioner, her state senator, her state representative and even the new federal secretary of health and human services. She said none of it helped.

"This almost became a full time job," Chipperini said.

During the fight, Chipperini said she was helped by the state Office of the Healthcare Advocate.

"The network can change and it can definitely change on an annual basis," said Ted Doolittle, CT healthcare advocate.

Doolittle said this case was tougher than most because of Chipperini's specialized health needs. However, it said it is a common problem.

"One of the things we're seeing across the industry is a move to what they call narrower networks," Doolittle said.

He said insurers have a lot of leeway in setting their networks. So he advised every customer to check every provider every time they enroll.

Often, even those who do end up hitting a brick wall trying to get information and need his agency's help.

Chipperini said she was so upset that Anthem made the change that she had to move.

She enrolled in her state's insurance plan and said her doctors are now covered without an issue.

Doolittle said the upcoming Obamacare showdown could lead to more people around the country facing that choice if some states are allowed to opt out of the Affordable Care Act.

"I think if those types of reforms go through it's quite possible that folks will feel like they need to move to another state to get a better insurance product," Doolittle said.

For her part, Chipperini said she is thankful there was an option. However, she said her home state let her down.

"I find it viscous, downright viscous and unAmerican that I have to leave my home," she told the I-Team. "I'm from Connecticut. I have a home in Connecticut, and I have to leave Connecticut and become a resident elsewhere so I can live, so I can stay alive."

The I-Team reached out to Anthem for a comment. While it was not authorized by Chipperini to speak about her specific case, it did say information went to all members saying out-of-state coverage would now only be available in an emergency and asking each customer to check if their doctors would be covered under the new network limit.

It also said it tried to work with Chipperini, which Doolittle also told the I-Team, but that the sides could not reach a resolution before she decided to move.

For more I-Team stories or to send in a tip, click here.

Copyright 2017 WFSB (Meredith Corporation). All rights reserved.