Bone barrow transplant, Certain death without ACA

I can offer a recent story.

He is currently taking care of his wife after a bone marrow transplant. So I write this in his stead.

As I was driving in my car, after picking up children from school, I received a call from a union plan. They had an urgent matter wherein a member was close to exhausting their transplant benefit and was still in need of a transplant. They wondered aloud if there was anything I could do to solve this problem. The union plan only allotted a $150,000 transplant benefit. The member was close to exhausting that amount and still hadn't conducted donor match services yet nor the transplant itself.

I advised the union plan that we needed to exhaust the transplant benefit, within the union plan, and then terminate the member. This would create a qualifying event. It afforded an opportunity to put her on a ACA plan which would pick up the remainder of costs associated with hospitalization and transplant.

For the record, an average bone marrow transplant is $1,000,000+. Working in conjunction with the union plan, we carefully watched each claim and waited to exhaust the member's benefit. When the moment arrived, I immediately transferred the member to an ACA plan without interruption of coverage. Interruption of coverage would have brought about certain death. I coordinated the member's care with UC Davis and verified benefits would, in fact, cover the totality of costs associated with the transplant and subsequent hospitalization for recovery.

As of February 14th, the member is scheduled to be released from the hospital to convalesce at home after a successful transplant. It cannot be stressed enough that a pre-existing condition of this magnitude would have rendered this member to certain death without the ACA.

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