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Hvatum sits at her dining room table in her suburban St. Louis home sorting through letters from her insurer. (Samantha Liss/KFF Health News)

After her insurer denied coverage of medication, she ended up in the ER

 What to know

Margaret Hvatum, a 70-year-old with primary immunodeficiency, faced insurance denials for her costly medication, leading to hospitalizations. Her Medicare Advantage provider, Humana, initially denied coverage for her medicine and hospital stays, later reversing decisions after appeals. Hvatum's case highlights the challenges of prior authorization in Medicare Advantage plans, prompting her to consider moving to Norway for universal health care.

Summary is AI-generated, newsroom-reviewed.

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