In an unfortunate turn of events, Linda Regen, a breast cancer survivor from Rehoboth, finds herself caught in a prolonged fight with her insurance provider, United Healthcare, over the approval of reconstructive surgery. Ten years after successfully defeating breast cancer through lumpectomy and radiation, Linda hoped to regain her sense of normalcy with reconstructive surgery, only to have her hopes dashed by multiple denials from the insurance company.

The ordeal began a few months ago when Linda's scheduled surgery was abruptly canceled due to United Healthcare's denial of preauthorization. Determined to get the procedure she believed was medically necessary, Linda filed an appeal, only to be denied three more times. The final denial letter cited the lack of evidence, such as photos or documentation showing a significant difference in the size of her breasts, as the reason for non-coverage.

Linda's oncologist, Dr. Nancy Lin, expressed her surprise and frustration with the situation, stating that in her more than 20 years of experience, she had never seen a surgery denial of this nature. Even the surgeon, who initially did not inform Linda about the denial, was taken aback by the insurance company's decision. While there is a law in place, the Women's Health and Cancer Rights Act, which mandates coverage for breast reconstruction after a mastectomy, the rules become murkier for long-term lumpectomy patients like Linda.

Dr. Lin emphasized that this surgery is not merely cosmetic but plays a vital role in a patient's overall mental well-being and recovery. For Linda, who constantly faces the reminder of the challenging chapter in her life, the denial becomes an impediment to moving forward and embracing her new life after cancer.

United Healthcare, while denying an interview request, issued a statement clarifying the use of evidence-based guidelines for coverage decisions and the need for additional documentation in Linda's case. However, Linda's doctors contend that the required documentation was not mentioned during the peer-to-peer review process.

Undeterred by the disappointing decision, Linda has vowed to continue fighting not just for herself, but for all cancer survivors who are subjected to unnecessary trauma due to insurance battles. She believes that this should be standard policy and that cancer survivors should not have to endure such difficulties.

In the meantime, Linda's doctors are planning to resubmit her case for review in hopes of obtaining coverage for the much-needed reconstructive surgery. As the fight for coverage continues, the hope is that Linda and others in similar situations will find a resolution that allows them to reclaim their sense of self and move forward in their healing journey.