Few people appeal rejected medical claims. It’s often worth it.

Summary

Apple News Today - Episode Summary

Title: Few People Appeal Rejected Medical Claims. It’s Often Worth It
Host: Shemitah Basu
Release Date: February 20, 2025

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1. U.S. President Donald Trump’s Controversial Remarks on Ukraine Conflict

Timestamp: 00:05 - 02:27

In the episode's opening segment, Shemitah Basu discusses President Donald Trump's surprising assertion that Ukraine is partly to blame for the ongoing conflict with Russia. Speaking during a press conference on February 20, 2025, Trump claimed responsibility for not ending the war earlier, stating, “Three years. You should have never started it. You could have made a deal for Ukraine that would have given him almost all of the land” [01:07]. This rhetoric has further strained relations between the U.S., NATO allies, and Ukraine, especially as both Ukraine and NATO officials were already dismayed by their exclusion from recent peace negotiations held in Saudi Arabia.

President Trump's comments included an incorrect statement about Ukrainian President Volodymyr Zelenskyy's domestic approval rating, falsely citing it at 4%, whereas recent polls indicate it stands above 50%. In response, President Zelenskyy accused Trump of echoing Kremlin propaganda, stating, “We understand that it is coming from Russia... unfortunately lives in this disinformation” [02:06].

Furthermore, retired General Keith Kellogg, Trump's envoy for Ukraine and Russia, arrived in Kyiv to engage with Zelenskyy, aiming to understand Ukraine's needs for peace talks with Russia. Concurrently, NATO convened its second emergency meeting of the week, addressing challenges to the alliance's foundational principles established in 1949, amid growing doubts about U.S. leadership among European members.

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2. Legal Turmoil Surrounding New York City Mayor Eric Adams

Timestamp: 02:27 - 07:18

Shemitah Basu shifts focus to New York City Mayor Eric Adams, who remains in his position despite mounting calls for his resignation following the Department of Justice (DOJ) decision to drop federal corruption charges against him. Acting Deputy Attorney General Emil Beauvais justified the DOJ's withdrawal by alleging that the prosecution was politicized and that the case was a distraction from Adams' duties, including cooperation with former President Trump's immigration policies [02:27].

The DOJ's unusual courtroom strategy, with Beauvais appearing alone without support from lower-level prosecutors, has sparked significant backlash. Notably, eight DOJ veterans and most of the Public Integrity Division's senior leadership have resigned in protest. Concurrently, Adams faces internal turmoil, evidenced by the resignation of four top deputies from his administration.

Katie Honan, a senior reporter for City, an online news outlet covering New York, provides insights into the unprecedented nature of the situation. She explains that Governor Kathy Hochul possesses the authority to remove Adams under the state charter and is considering this option. Additionally, the City Council can form an “Inability Committee” — a novel and never-before-utilized body — to potentially oust the mayor [05:41 - 06:21].

Honan attributes Adams' reluctance to resign to his political ties with President Trump, who is actively seeking to have the charges dropped to maintain his influence in New York City politics. With Mayoral primaries scheduled for June and the general election in November, Adams has hinted at the possibility of switching parties to run as a Republican if he remains in office. Honan remains cautiously optimistic about Adams' political viability, noting his effective campaigning and relatable messaging, which resonates with many voters [06:34 - 07:18].

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3. The Importance of Appealing Denied Health Insurance Claims

Timestamp: 07:18 - 10:44

A significant portion of the episode is dedicated to the often-overlooked process of appealing denied health insurance claims. Basu highlights that while health insurers process over 5 billion claims annually, approximately 17% are denied, equating to around $850 million each year. Despite less than 1% of patients appealing these denials, research indicates a high success rate of about 75% for those who do [07:18 - 08:07].

Julie Wernow from the Wall Street Journal elaborates on the barriers preventing individuals from appealing denied claims. These include feelings of futility, intimidating paperwork, misplaced trust in insurers' decisions, and the overwhelming stress associated with medical issues [08:01 - 08:29]. Wernow shares the poignant story of Emily Beck, a young girl who developed an inflammatory brain disease following a COVID-19 infection. Her family's struggle to secure coverage for a necessary and costly infusion therapy underscores the emotional and financial burdens faced by many [08:29 - 10:25].

Through persistent appeals and comprehensive documentation from healthcare providers, the Beck family ultimately succeeded in obtaining the necessary treatment from UnitedHealthcare, a victory that brought immense relief and hope [09:49 - 10:25]. Wernow offers practical tips for those considering an appeal: thoroughly research insurance coverage, meticulously document all communications, and act swiftly to meet appeal deadlines [10:25 - 10:44].

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4. Additional News Highlights

Timestamp: 10:44 - 12:15

Shemitah Basu briefly touches on several other pressing news stories:

• Hostage Remains Returned by Hamas: Hamas returned the bodies of four hostages, including young children and the elderly, as part of an accelerated exchange with Israel. This follows the earlier release of their husband and father, Yarden Bibas [11:16 - 12:15].

• Immigration Updates: New ICE data reveals that 41% of detentions under the Trump administration involve individuals without criminal convictions or pending charges. Additionally, the administration has ceased a program providing legal representation to nearly 26,000 immigrant children, many of whom are unaccompanied or lack legal guardians [12:15].

• Hockey Championship Rematch: The United States and Canada prepare for a rematch in the four nations Face Off Tournament after a chaotic initial game marked by multiple fights. The Athletic provides analysis and predictions for the championship showdown [12:15].

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5. Upcoming Features and Conclusion

Timestamp: 12:15 - End

Basu concludes the episode by promoting upcoming content available on the Apple News app, including a narrated article from The Atlantic examining the significant social shift of reduced interstate and intracity migration among Americans over the past fifty years. She encourages listeners to stay tuned for future episodes and additional stories [12:15 - End].

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Key Takeaways

• Trump's Blame on Ukraine: President Trump's recent remarks have exacerbated tensions between the U.S., Ukraine, and NATO allies, with significant implications for international relations and peace negotiations.

• Mayor Adams' Legal Crisis: New York City's Mayor Eric Adams faces unprecedented political and legal challenges following the DOJ's controversial decision to drop corruption charges, leading to significant administrative resignations and potential removal from office.

• Health Insurance Appeals: Despite high success rates, the vast majority of denied health insurance claims go unappealed due to emotional, logistical, and informational barriers. Persistent appeals can lead to favorable outcomes, as demonstrated by the Beck family's experience.

• Broader News Coverage: The episode also provides updates on international hostage situations, immigration policy changes, and upcoming sports events, ensuring listeners are well-informed on a variety of critical issues.

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For more detailed reporting and additional stories, listeners are encouraged to visit the Apple News app and explore the latest articles and features.

Transcript

[Shemitah Basu]

Good morning. It's Thursday, February 20th. I'm Shemitah Basu. This is Apple News Today. On today's show, a couple ways New York City Mayor Eric Adams could lose his job. Why it's worth your time to fight a denied health insurance claim. And in hockey, the United States and Canada, fresh off last weekend's brawl, face off again tonight. But first, almost three years to the day after Russian tanks first invaded Ukraine, President Trump shocked Ukraine and European allies by blaming Ukraine for the war, further straining relations between the US and its NATO and Ukrainian allies. Remember, Ukraine and members of the NATO alliance were already upset that Russia and the United States excluded them from peace negotiations in Saudi Arabia on Tuesday after. And Trump's lie about how the war started came during a press conference Tuesday evening in response to a reporter's question about how those talks went.

[Donald Trump]

Here's the president and I think it's going very well. But today I heard, oh well, we weren't invited. Well, you've been there for three years. You should have ended it. Three years. You should have never started it. You could have made a deal. I could have made a deal for Ukraine that would have given him almost all of the land.

[Shemitah Basu]

The war began in February of 2022 when Russia launched a full scale invasion of Ukraine from three sides with troops, tanks and airstrikes targeting cities, military bases, schools and hospitals. Tens of thousands of people were forced to flee their homes. It was the biggest attack on a European nation since World War II. In Tuesday's press conference, Trump also incorrectly claimed President Zelensky has a 4% domestic approval rating. According to polling from this month, Zelenskyy's approval rating is above 50%. And Zelensky, in response to Trump's comments, accused the president of parroting talking points from the Kremlin.

[Volodymyr Zelenskyy]

Since we are talking about 4%, we have seen this disinformation. We understand that it is coming from Russia. We understand and we have evidence that these numbers are being discussed between America and Russia. It is unfortunate that President Trump, and with great respect for him as the leader of the American people who constantly support us, unfortunately lives in this disinformation.

[Shemitah Basu]

Space during Tuesday's press conference and on social media. In response to that comment from Zelenskyy, you just heard Trump called Zelenskyy a dictator and suggested the Ukrainian president should not be in power. Elections in Ukraine were supposed to happen in 2024, but they've been suspended during wartime under martial law. A survey of Ukrainians conducted last year found 70% of people supported allowing Zelenskyy to remain in power until martial law is lifted, and Zelenskyy's administration has said it plans to hold elections immediately after the war has ended. Trump's envoy for Ukraine and Russia, retired general Keith Kellogg, arrived in Kyiv on Wednesday to meet with Zelenskyy. He told reporters upon arrival that part of his mission will be to listen to what Zelenskyy wants from U s. Russia peace talks Meanwhile, members of NATO held their second emergency meeting this week on Wednesday, this time including nations that were not at the previous meeting to discuss how to recalibrate their relationship with the United States. The Wall Street Journal reports that this moment feels particularly difficult for European members of NATO to navigate. NATO was created in 1949 as a way for the United States to support the rebuilding of Europe after the Second World War. At the time, the US viewed an economically and militarily strong Europe as crucial to prevent preventing communist expansion across the continent. Now, it seems the premise of that alliance is being tested and European leaders are questioning the US's leadership in a new way. New York City Mayor Eric Adams still has a job for now. There's been a lot of talk about whether the mayor will volunteer to step down or if he'll be forced out. All of this after a wave of criticism following the DOJ's move to drop federal corruption charges against Adams, charges he pleaded not guilty to. Yesterday, the acting deputy attorney general, Emil Beauvais, appeared in court before a federal judge to justify why the DOJ was asking to drop the case. Adams was there, too. Bove said the move to drop the charges was not based on the strength of the evidence, that the prosecution was politicized and tainted it and he said the case was distracting the mayor from doing his job, which he wrote in an earlier memo included cooperating with Trump's immigration enforcement plans. The judge did not issue an immediate ruling leaving the charges in place for now. The Washington Post describes it as highly unusual for a senior department official like Bove to personally argue a case in court and to do it alone without the assistance of lower level prosecutors. But since Bove ordered the dismissal of Adams case, eight veterans of the department resigned in protest, as did most of the senior leadership of the DOJ's Public Integrity Division. Meanwhile, for Adams, this case and the suggested quid pro quo behind dropping it led to the resignations of four top deputies in his administration this week. There have been numerous calls for Adams to resign, which he has so far refused to do, and calls for governor Kathy Hochul to remove him from office.

[Katie Honan]

She's given the authority in the state charter to be able to do that.

[Shemitah Basu]

Katie Honan is a senior reporter for the City, an online news site covering New York. She told us Governor Hochul says she's considering it. The other possible way to remove him from office would involve an obscure body assembled by the City Council, what's known.

[Katie Honan]

As the Inability Committee, which is a special committee that convenes to remove the mayor. And it's made up of five people.

[Shemitah Basu]

Those five people are the City council speaker, the city comptroller, one deputy mayor, the city's top lawyer, and the borough president who served in their position the longest. Honan told us this is all unprecedented.

[Katie Honan]

A governor has never removed a mayor of New York City, and the Inability Committee has never been formed. I know that there's been plenty of other mayors with investigations and other scandals, but nothing like this has ever happened, and it's never really been required.

[Shemitah Basu]

We asked Honan, why is Adams so adamant about holding onto an office amid serious allegations of corruption, low public approval, high profile resignations, and the prospect of being removed from office? And she says the reason is a pretty simple equation.

[Katie Honan]

There's the political maneuvering of he's really only useful to President Trump, who's personally trying to get his charges dropped if he's mayor of New York City.

[Shemitah Basu]

The timing of all this matters as well. New York holds a mayoral primary in June, with the general election in November. Adams, a Democrat, has floated the idea of maybe running as a Republican should he survive this and run for re election. Honan says she wouldn't count him out just yet.

[Katie Honan]

I don't know his chances, but again, he's a very skilled campaigner and his message when he's been out is this message of we've all faced adversity. You've had challenges, I've had challenges. I am you. That's his message. And I think to some voters that actually resonates.

[Shemitah Basu]

Health insurance companies process more than 5 billion claims a year. Roughly 17% of those claims are denied. That's 850 million every year. But research shows the people who do appeal, which is less than 1% of patients with largely get those claims approved.

[Julie Wernow]

About three quarters of those people are successful, and so that's a pretty good figure.

[Shemitah Basu]

Julie Wernow covers health for the Wall Street Journal, and she told us why, despite this success rate, many people don't file an appeal when their claim is denied. She says some feel like there's no point. Others are daunted by the paperwork. Some are too trusting that insurance companies were right to deny their claim. And many people are simply overwhelmed by the medical issues they're facing.

[Julie Wernow]

When someone gets a denial, often they might be in one of the worst emotional moments of their life. And so that prevents a lot of people from moving forward.

[Shemitah Basu]

She told us about one family's journey through the claims system. Emily Beck contracted COVID 19, and viral pneumonia when she was in kindergarten in 2021.

[Julie Wernow]

After she got better from the illness, her mom noticed a remarkable change in her. She said she was like a totally different little k. She was suddenly having really horrible behavioral problems and all sorts of issues. And it turned out that she had an inflammatory brain disease that was affecting her in multiple ways. And no one in their area seemed to be able to treat Emily. It was a really rare condition.

[Shemitah Basu]

By this time, Emily was 9 years old, and a specialist recommended an infusion therapy that, according to one study, could potentially improve her symptoms significantly. But their insurer, UnitedHealthcare, wouldn't cover it.

[Julie Wernow]

They kept getting denial after denial for this treatment. First, you know, they said that this treatment was out of network for their pharmacy. That was two months of delays. Then the insurer came back and said they actually didn't think that this treatment was medically necessary. They didn't think it was provable.

[Shemitah Basu]

Insurance companies argue to remain solvent, they have to make calls on which types of medical care merit reimbursement and which don't. But with rare conditions, because the number of cases are so small, it can be difficult for patients to find documentation that proves a drug or treatment works. Paying out of pocket for Emily's treatment would have cost her family close to $36,000, much more than they could afford. It took Multiple appeals to UnitedHealthcare and a team of care providers who provided documentation to prove her treatment was necessary and urgent before the Beck family got approved.

[Julie Wernow]

They were just thrilled. You know, they were toasting with champagne. Even Emily really understood that it was a big moment. She had seen her mom cry multiple times trying to get her treatment and help. And so the next phase is actually waiting to see if it works.

[Shemitah Basu]

Warnow put together a list of tips to make appealing a denied claim Less daunting. She said, first, research what your insurance plan covers. Take notes from any calls with insurance that you have, including the name of who you spoke to. And she recommends acting quickly. Many insurance companies have deadlines for filing appeals that you'll want to be aware of. We'll link to her reporting and tips in our show notes page in the Apple news app. Before we let you go, a few.

[Unnamed Reporter]

Other stories we're following. Hamas returned the bodies of four hostages today, including those who are believed to be the youngest and one of the oldest hostages. They include the remains of Ariel and Kfir Bibas, who were four years old and nine months old when they were taken. Their mother Shiri and 83 year old Oded Livchutz all were taken from their homes in the same kibbutz on October 7. The Bebas family had come to symbolize.

[Shemitah Basu]

The horrors suffered by those captured by.

[Unnamed Reporter]

Hamas after video circulated showing Shiri clinging to children while surrounded by militants. Her husband Yarden was released alive earlier this month. Thursday's return of remains and the freeing of six living hostages on Saturday are part of an accelerated exchange by Hamas and Israel announced earlier this week. Israel agreed to free more than 100 Palestinian prisoners and allow mobile homes and heavy trucks into Gaza to remove rubble.

[Shemitah Basu]

Onto Some Immigration Updates New data from Immigration and Customs Enforcement shows the Trump administration administration is not exclusively arresting criminals as it promised to prioritize. Data obtained by NBC reveals the number of people detained in ICE custody without a criminal conviction or pending criminal charges represent 41% of the total new detainees from the first two weeks of February and yesterday, the administration halted a program that provided lawyers to nearly 26,000 children who are immigrants. Many of them don't have parents or legal guardians in the United States. Some are too young to read or speak. Peak and finally, did you watch the hockey match between the United States and Canada on Saturday where three fights broke out during the first nine seconds? Well, the teams will be back on the ice tonight for a rematch. It's the championship game of the four nations Face Off Tournament. The Athletic looks at the biggest surprises and best moments of the tournament so far and makes some predictions about which team has the edge to come out on top. You can find all these stories and more in the Apple News app. And if you're already listening in the news app right now, we've got a narrated article coming up next. The Atlantic looks at why over the past 50 years Americans have become less likely to move from one state to another, or even one city to another, calling this the single most important social change of the past half century. If you're listening in the podcast app, follow Apple News plus narrated to find that story. And I'll be back with the news tomorrow.