Insurance policy delays man’s life-saving transplant

By Katara McGee

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CINCINNATI, Ohio (WLWT) – A Kenwood man’s search for a life-saving lung transplant is complicated by finding a way to pay.

Last winter, Mark Plummer, 55, was in good health. He worked as a delivery driver and said he had never even had an operation or a broken bone.

In February 2021, he began to experience shortness of breath. In May, he was diagnosed with interstitial lung disease.

Four words in its front yard give passers-by an idea of ​​the mountain it faces. A sign reads: “We believe in miracles”.

“It’s scarring of the lungs, it’s progressive and it’s incurable,” said Mark Plummer. “It is a progressive disease and there are only two outcomes. It’s either you get a lung transplant and I hope to survive, or I’ll end up dying.

The disease causes stiffness in the lungs, making it difficult to breathe or get oxygen into the blood.

“It’s something I wouldn’t want my worst enemy to go through,” Linda Plummer said.

Her husband is on oxygen 24 hours a day. They learned he would need a transplant to survive several months ago.

Mark Plummer performed all the required pre-transplant tests and was told by his doctors at Wexner Medical Center in Ohio State that he was an ideal candidate for the transplant.

But a phone call a few weeks ago about his insurance brought the Plummers to their knees.

“They have a clause in their policy that they don’t cover organ transplants,” Mark Plummer said. “I was devastated. After mentally preparing myself to undergo a double lung transplant, which is far from a minor procedure, I was crushed.

When he fell ill, Mark Plummer had just quit his job as a delivery driver at Klosterman Baking Company, preparing to start a new job. Then he ended up in the hospital, his condition worsened and he never returned to work. He became disabled within a few weeks.

Under COBRA, a federal law, he was allowed to retain his employer-based coverage from Klosterman Baking Company at a higher cost. But the problem is that Klosterman’s medical plan doesn’t cover organ transplants.

Without insurance, the Plummers learned that the estimated cost of a transplant and rehab was half a million dollars.

“Someone somewhere is playing God,” said Mark Plummer.

“It’s so unfair. And it could happen to anyone,” Linda Plummer said.

The two looked forward to retirement, spending their days walking around the neighborhood, going to concerts and traveling. Those plans are in jeopardy, even if Mark Plummer receives a transplant and survives.

“We were going to have to liquidate our pension funds. We had decided that if I wasn’t living to take advantage of the retirement funds, what good was it?” he said.

Wexner Medical Center was able to put Mark Plummer on the transplant waiting list a few days ago. He is currently hospitalized with a large supply of oxygen and is awaiting a transplant.

Linda Plummer tells WLWT that finances are still up in the air, but there is hope.

The family set up an online fundraising page through the non-profit Help Hope Live to raise money for medical costs. Donations are tax deductible.

Klosterman Baking Company issued the following statement to WLWT.

“Klosterman Baking Company provides employer-sponsored health care to its associates and, pursuant to the Consolidated Omnibus Budget Reconciliation Act (COBRA), the Company provides former employees with COBRA continuation coverage. This temporary extension of benefits is identical to the medical coverage the person had while employed. Klosterman’s employer-sponsored medical plan does not cover transplant procedures or related services for current or former employees who choose to enroll in the COBRA plan.

“Any former plan member has several options for health care coverage. They can buy coverage from their new employer; they can opt for COBRA coverage through Klosterman Baking Company; or they can purchase coverage in the health insurance market, where many plans are available with different forms of coverage, including transplant services. Employer-sponsored coverage from a current employer or from the health insurance market would likely be cheaper than the COBRA coverage provided by Klosterman.

“As always, Klosterman Baking Company is ready and willing to help any plan participant find a suitable plan and work with current employers, the health insurance market, or other programs like Medicaid if they need it. .”

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