A video highlighting a patient’s battle with United Healthcare is picking up traction online, both on TikTok and Reddit. The TikToker, Gillian Foxglove, who goes by @gillianfoxglove on the platform, shared the story of her cousin, Nora, a doctor of physical therapy who is currently dealing with a serious medical condition. In the video, which has already reached 26K views, Foxglove explains that Nora has a cavernoma bleed, which she identifies as a form of stroke. According to Foxglove, Nora’s medical team has been clear about the necessary path forward. “She has been advised by multiple surgeons at this point that she should be getting a surgery called a laser ablation surgery. This surgery would target the specific area where the cavernoma is,” Foxglove said in the clip. “And United Healthcare has denied it on the grounds that it’s an experimental surgery, all the while recommending that she get a complete resection, which is not only a significantly higher cost, it is also a higher risk,” she explained. Foxglove noted that the vascular lesion is located in the thalamus, which serves as the sensory relay center of the brain. As you can imagine, it affects all her motor functions “When it bleeds, it then affects the timing and quality of her sensory system, making it difficult to coordinate movements and has made her weak,” she said. “The more the lesion bleeds, the higher the likelihood that the damage becomes more permanent and extensive. As the lesion grows, she will be at a severe risk for hydrocephalus, which can be life threatening.” The resulting symptoms, Foxglove stated, have been life-altering. They include double vision that has cost Nora her ability to drive, severe fatigue, and an inability to perform basic tasks like writing or holding a water bottle. Foxglove emphasized that the surgeon even provided a four-page paper detailing why the laser ablation is the superior option for her specific case, but the insurance company remained unmoved. @gillianfoxglove Please please share this if you can. Shame on United healthcare! We’re not asking to raise money at this point just trying to get UHC to reverse their decision. You can find her on insta at ptflipside #unitedhealthcare #healthcare ♬ original sound – Gillian Foxglove Users on the TikTokCringe subreddit discussed the implications of insurance companies overriding medical advice, with the post title pointing out, “Because obviously they know more than doctors.” One redditor, vazmitamuspus, stated, “insurance shouldn’t be allowed to deny life saving treatment, period.” Another redditor, Thereminz, suggested a cynical motive. They noted, “gee it’s almost as if they have a financial incentive to tell you to get the worse surgery so that you’ll have to keep paying them more money.” On TikTok, users came forward with practical advice. User friendlymuffinboy pointed out, “By law, insurance must allow you to appeal to a 3rd party reviewer. This is often the best shot at getting something approved.” Similarly, Marc Pharmtech suggested, “Have the doctor request a peer-to-peer review with the insurances medical director.” Foxglove responded to these suggestions, clarifying that the hospital and surgeons are fighting just as hard as the family and have likely already initiated those steps. Because obviously they know more than doctors byu/newphonehudus inTikTokCringe According to NBC, Sally Nix, a patient advocate who has fought her own insurance battles, says that these denials are often “overwhelming by design.” The system of prior authorization is used by nearly all insurers to control costs, but it frequently results in patients facing significant hurdles to access necessary care. NBC reported that while denials can be appealed, the process is often described as difficult. Experts recommend that patients keep meticulous records, including every phone call and letter, to build a strong case. They also suggest working closely with providers to request peer-to-peer reviews, where a doctor can speak directly with a medical professional at the insurance company. The outlet wrote that there are resources available for everyone. Organizations like the Patient Advocate Foundation offer guidance. Additionally, some states reportedly have consumer assistance programs to help patients navigate the appeals process. It is also worth noting that if a health plan is self-funded by an employer, the employer may have the final say on coverage decisions, making HR departments a potential avenue for assistance. However, Jorgensen, an advocate for patients with disabilities, had one warning: “If it isn’t on paper, it didn’t happen.” Comment byu/newphonehudus from discussion inTikTokCringe Nora isn’t the only person struggling with United Healthcare. Recently, a New York dad shared a United Healthcare letter that was sent to his newborn daughter, denying her stay in the NICU. In another instance, a doctor was forced to scrub out, mid-surgery, to justify the hospital care and stay of the patient that was on her table. For now, the family continues to advocate for Nora, hoping that the necessary surgery will be approved before the condition worsens. As Foxglove concluded in her video, “United Healthcare can and should allow her to get this procedure done. It is that simple.”