Podcast Summary: "Insurance Denials Feel Like a Death Sentence"

Podcast Information

• Title: Uncared For
• Host: Soojin Pak (Lemonada Media)
• Episode: Insurance Denials Feel Like a Death Sentence
• Release Date: August 13, 2025

Introduction

In this poignant episode of Uncared For, host Soojin Pak delves into the harrowing experiences of Kay Su, a breast cancer patient and advocate. Through Kay's story, the episode illuminates the critical failures within the U.S. healthcare system, particularly focusing on how insurance denials can jeopardize lives.

Kay Su's Cancer Journey

Initial Diagnosis and Life Changes

Kay Su was in her mid-30s, thriving in her career at Instagram, and newly engaged when she faced an unexpected life-altering event. In January 2015, while walking to a cat cafe in New York City, Kay revealed to a colleague her plan to skip a gynecological appointment due to a conflicting work meeting. Encouraged by her colleague to prioritize her health, Kay attended the appointment, leading to a life-changing diagnosis.

• Quote (Kay Su, 02:14): "I'm going to skip this gynecological appointment... her encouragement saved my life because it was at that appointment two weeks later that I found out through a normal check that I had a big lump."

Shortly after her diagnosis, Kay was devastated to learn she had stage three breast cancer. Balancing her career and personal life became a steep uphill battle as she navigated the initial treatment phase.

Remission and False Hope

Following her successful initial treatment, Kay experienced a period without evidence of cancer, fostering a sense of hope and transformation. She adopted healthier lifestyles, including quitting drinking and altering her diet, believing she was on the path to recovery.

• Quote (Kay Su, 09:12): "That year that I had cancer, I felt like my life was transformed. I was given this other chance."

Recurrence and Stage Four Diagnosis

However, in 2018, during a routine scan, Kay discovered that her cancer had metastasized to her spine and bones. This devastating revelation marked her transition into stage four cancer.

• Quote (Kay Su, 10:22): "I was just shocked. I thought I put everything behind me. I was ready to move on."

Battle with Insurance

Denial of PET Scans

As Kay embarked on aggressive immunotherapy treatments, she faced another significant hurdle: the denial of coverage for her necessary PET scans by her new insurance provider after changing jobs in early 2024. The insurer deemed her condition "stable" and medically unnecessary for further scans, despite medical advice to the contrary.

• Quote (Kay Su, 15:26): "They denied coverage... it just makes no medical sense, like, insane."

Appeals Process

Kay's attempts to appeal the denial were met with bureaucratic obstacles. Her oncologist's engagement with the insurer's medical director was insufficient to overturn the decision, and alternative options like chest CT scans were also rejected.

• Quote (Kay Su, 19:16): "It's horrific. It's a horrific process."

The appeals process proved to be an arduous and emotionally draining experience, highlighting the systemic barriers patients face when seeking necessary medical care.

Emotional Toll

The denial of coverage not only threatened Kay's health but also led to profound feelings of anger and helplessness. She expressed frustration over insurance companies prioritizing profits over lives, equating denials to sentences of death.

• Quote (Kay Su, 19:46): "Every denial to me feels like someone's telling you, nope, you're dying, you're going to die."

Broader Healthcare System Failures

Impact on Patients

Kay's story is a stark representation of how insurance denials can have life-or-death consequences. The process is often impersonal and profit-driven, leaving patients with little recourse and immense stress.

• Quote (Kay Su, 20:59): "I'm dying from lack of access to healthcare that I have paid for and supposed to be there."

Systemic Profit-Driven Issues

The episode underscores the systemic issues within the U.S. healthcare system, where insurance companies and third-party reviewers prioritize cost-saving over patient care. This profit-driven approach exacerbates healthcare inequities and undermines trust in medical institutions.

• Quote (Kay Su, 23:02): "It's not just not covering a cavity, you know, or root canal. It meant that if you turn down one thing, you turn down everything."

Advocacy and Call for Change

Kay's Advocacy Efforts

Faced with such systemic failures, Kay transformed her personal struggle into advocacy. She emphasizes the need for collective action and systemic overhaul to ensure that insurance companies fulfill their obligations to cover necessary medical treatments.

• Quote (Kay Su, 29:00): "We need to have conversations about what tomorrow looks like... we need collective action on this."

Collective Action Needed

Kay calls for increased accountability among elected officials and a unified effort to prioritize healthcare equity. She criticizes the lack of political will to address these systemic issues, urging listeners to hold policymakers accountable.

• Quote (Kay Su, 29:00): "Where are our elected officials? Very, very, very few elected officials talk about this."

Personal Life and Resilience

Parenthood and Living with Cancer

Amidst her battle with cancer and insurance denials, Kay found profound purpose in motherhood. Her daughter, Freya, born via surrogate in 2021, became a central source of joy and motivation. Kay balances her advocacy with dedicated parenting, cherishing everyday moments with her daughter.

• Quote (Kay Su, 31:01): "It was one scan that made the difference between her getting sicker and even dying versus having more and more of these everyday moments with her family."

Conclusion

In "Insurance Denials Feel Like a Death Sentence," Uncared For powerfully illustrates the life-threatening implications of insurance denials within the U.S. healthcare system. Through Kay Su's relentless fight, the episode highlights the urgent need for systemic reform to ensure that medical care serves the people, not profits. Kay's journey is a compelling call to action for collective advocacy and policy change to prevent others from facing similar ordeals.

Notable Resources Mentioned:

• ProPublica's Claim File Helper: Assists patients in navigating insurance claim denials.
• Fight Health Insurance: Provides free tools for creating appeal documents.
• The Dose Podcast by the Commonwealth Fund: Focuses on health policy conversations.

Further Actions:

• Request Your Claim File: Understand why your insurance claim was denied.
• Learn About Appeals: Utilize available resources and AI tools to increase the chances of overturning denials.

Closing Thought: As Kay Su poignantly states, "Insurance should work for us, not for higher profits." Her story is a testament to the resilience of patients navigating a flawed system and underscores the critical need for healthcare equity and reform.