Koreen Holmes

Eau Claire

Eight months into my pregnancy, my husband and I were focusing on final doctor appointments and diapers. It was during this time that I learned that I had breast cancer and the world inhabited by my growing family turned from vibrant color to black and white.
I faced a life-or-death decision at the young age of 32. The obvious choice—life—meant many months of cancer treatments and powerful medication.
Nate, my husband, and I welcomed our son into the world on January 28, 2021. My cancer treatments at Prevea Cancer Center at HSHS Sacred Heart Hospital in Eau Claire began six days later. I received infusions every three weeks.
Despite the curveball we had been thrown, we remained positive, bolstered by the fact that my life-saving medications were working.
Then came July 1.
We found out our insurance wasn’t going to pay for the medication anymore because the company put a new policy in place that dictated where we had to get the medicine from—something called “white bagging,” Nate explained to me.
This new insurance practice, we learned, required my medication to be dispensed by a different pharmacy, one specified by our insurer. Why the pharmacy of my health care provider, which is in my insurer’s network, could no longer supply the medication did not make sense to us. My medication would then need to be mailed to the hospital for my health care provider to administer.
What’s most baffling about this process is that my medication was already on-hand at the hospital pharmacy. With expensive immunotherapy medications like mine, my health care providers, in whom I place complete trust, could not guarantee the timeliness, efficacy or safety of the medicine received from a distant supplier, unlike the medicine they had been providing me all along and which I so desperately needed.
Nate and I spent two hours on the phone trying to connect with someone at our insurance company. We received no answers and no explanation for this new policy that made any sense.
As new parents and faced with a serious medical condition, we struggled to navigate the complexity of this insurance policy. The responsibility to figure it all out was unfairly placed on us, the insurance customer. Putting this burden on a cancer patient is inhumane.
“I’m a cancer patient. I shouldn’t have to be worrying about this,” I thought. I was being told to put decisions about my health care and where and how I get my expensive medication into the hands of an insurance company. It was scary. And frustrating.
I am extremely thankful to the staff at Prevea Cancer Center, who shared my frustration. They spent six hours with Nate at the facility in October making phone call after phone call to the insurance company. They pleaded with them to let continue paying for my hospital-provided medication.
The alternatives were terrifying. Nate called it a fiasco. I had to either take a medicine that could be dangerous at a new location we were unfamiliar with, or we would have to pay thousands of dollars out-of-pocket.
It was never about the money. Nate and I talked at one point about filing bankruptcy or draining our savings so we could keep getting treatment with the people who had been taking such good care of us. Whatever we had to do would be worth it, we thought. The insurance company clearly had no idea the ripple effect their policy was having on our lives.
Nate called me after those six hours on the phone with his insurance company. No progress had been made. Tears followed. While we were speaking, twelve minutes before the end of the business day, the phone at Prevea rang. It was the insurance company. They approved 90 days of additional care with safe, regulated hospital-provided medicine. More tears flowed—this time, happy ones.
This 90-day reprieve from white bagging was just enough time for me to get me to my final cancer treatment in January.
Nate and I have been humbled by this experience, and cannot thank the team at Prevea Health enough for the time and resources they invested in helping us through this challenge. We are now putting our trust and faith in Wisconsin’s Legislature and Governor to take action by writing and passing a bill that will prevent all insurance carriers from practicing white bagging. It has to stop for the sake of patients’ lives.
And if you think the insurance company has or will soften its position, think again. Less than two weeks after being granted my 90-day continuance of care, our insurance provider notified the Prevea Cancer Center at HSHS Sacred Heart Hospital that a second continuance of care request for necessary follow-up treatments will be denied; and no appeals will be entertained.