Gabrielle Guerrero was 15 when docs instructed her that her life would by no means be the identical.
“They have been like, ‘You’re younger and energized, however you’ll by no means be capable to stroll once more with out help,’” stated Guerrero, of Burleson, Texas, a suburb of Fort Price.
She had been driving in an off-road automobile together with her siblings when it hydroplaned and flipped. Guerrero’s left foot caught within the door. After greater than two weeks within the hospital and two surgical procedures, it in the end needed to be partially amputated. Guerrero misplaced all of her toes and about half of the entrance of her foot.
To get round comfortably, Guerrero, now 21, wears a customized prosthesis.
“Once I stroll barefoot on arduous flooring, it’s very, very painful, I can really feel the callous, the stress on it,” she stated. “So after I put on that prosthetic, it takes that stress off.”
However six years later, the prosthesis had worn down. Two of the faux toenails had fallen off and a tear down the again made it troublesome to remain in place. “It was actually disintegrating,” she stated.
That first prosthesis had been absolutely coated by Guerrero’s insurance coverage supplier, Aetna. Nevertheless, Aetna denied protection for the brand new prosthesis, writing in a September letter that the request was “improperly coded” and a prosthesis “for look, consolation, or comfort will not be thought-about medically mandatory.”
“I used to be actually simply in tears due to the anger,” she stated of the denial. “I don’t perceive how consolation isn’t medically mandatory.”
In case you are coping with payments that appear to be out of line or a denial of protection, care or repairs, whether or not for well being, residence or auto, please e mail us at Costofdenial@nbcuni.com.
She had a deadline in thoughts: her December faculty commencement, the place she hoped to stroll throughout the stage sporting the brand new prosthesis.
NBC Information reached out to Aetna for remark eight days earlier than Guerrero’s commencement. A spokesperson stated the corporate would look into the main points of her case.
A number of days later, Guerrero obtained a second denial.
With the date quickly approaching and no decision, her mom made the choice to place the $7,500 value for the prosthetic on a bank card. The system was able to go, however Guerrero could not take it residence till it was paid for.
