Insurance Coverage: Florida Tumor Patient's $993,000 Bill Reduced to Zero

Florida’s insurance market has long been a point of contention for patients and providers. On October 29, Broqsten Bunt, a 36-year-old West Palm Beach resident, reported that his financial burden from a complex brain tumor surgery has been eliminated.

Bunt stated that the total retail value of his medical care was $993,000. He confirmed to reporter Katie LaGrone that his current balance is zero. This follows a dispute with Florida Blue that began in June of this year.

The dispute centered on an out-of-network neurosurgeon. Although Tampa General Hospital is an in-network facility for Bunt, the specific surgeon recommended for his case was not. Florida Blue denied an appeal for additional coverage for this out-of-network care just before the scheduled operation. The hospital and insurer did not provide a specific reason for the eventual reversal of the coverage decision.

Bunt underwent the surgery in June despite the pending denial. He described the period between the surgery and the resolution as a chaotic period of communication. He noted that he was receiving calls from both the medical office and the insurance company. He said, 'I'm like, I don't write the bills, I don't pay the bills. Why are you calling me? Call each other and figure it out.'

During an interview in his recovery room in June, a Tampa General Hospital spokesperson interrupted to announce that hospital leadership had worked with Florida Blue. The insurer agreed to cover the preoperative workup, surgeries, hospital admission, and postoperative care. At that time, neither party explained what prompted the change in coverage.

Five months later, Bunt reported that he is medically cleared. He said his strength has returned and he has no future medical needs or prescriptions. A Tampa General Hospital spokesperson confirmed that his insurer paid the full hospital portion of his claim. The hospital also worked with Bunt to reduce his deductible to zero.

Bunt went through two denied appeals before the insurer reversed course. He and his wife used social media and the news media to draw attention to his case. Bunt believes the public awareness generated by the news coverage was the primary factor in the reversal. He said, 'It didn't take any added information for them to change the denial process. It took the news making the population aware.'

Florida Blue stated it cannot discuss individual cases but said it is pleased when it reaches positive outcomes for members. The insurer noted it works with members, doctors, and hospitals through its appeals process. Bunt said the resolution demonstrates the difficulty patients face when challenging insurance denials.

Bunt offered advice to other patients facing similar denials. He said, 'Don't back off the gas.' He emphasized the need to keep pushing and reaching out to people to secure the necessary care. He added, 'You can deal with the details after. If you're not here, you don't have to worry about the details.'

Bunt is a childhood leukemia survivor. Doctors believe the aggressive meningioma he developed was connected to radiation therapy he received as a child. His case illustrates the financial risk associated with out-of-network referrals in complex medical cases.