Patients say more claims for cancer screenings and treatments rejected by insurance companies

Kay Su has been battling cancer for nearly a decade. One of the hardest moments was in 2018. The cancer returned, stage four, metastatic. Did it feel like a death sentence in that moment? Absolutely. And it still does. It's just, it's almost like being on death row and just waiting. All of my off-label drugs. Remarkably, she was able to battle the cancer back, but her oncologist said it could return again. And PET scans were key to detecting it. How often do you have to get the PET scans? Should be four to five months. A schedule she followed until her private health insurance changed to Cigna. And she says the company wouldn't pay for the screening. They thought it was not medically necessary. Does your oncologist think it's medically necessary? Yeah. So does Dr. Ashley Sumrall from the American Society of Clinical Oncology. PET scans are all part of accepted guidelines. That means that multiple experts agree that a PET scan is appropriate. But Cigna refused to pay for the scans, which can cost $10,000 to $15,000 each. Sue's doctor appealed and was denied. With the delay in her screening, Sue worried the cancer would return. Angela Pike understands that struggle well. Her husband, Tracy, was diagnosed with stage four stomach cancer in 2023. He was so sick, he went from a 250 pound man to about 130 pounds. Tracy's doctors in Louisville ran out of strategies to help him. They said he needed Hypec surgery, a kind of chemotherapy that a cancer center in Houston agreed to perform. It was about 10 or 11 o'clock at night, the night before the surgery, where we got a phone call that, from the surgeon himself, that the insurance had actually denied the surgery. In the denial letter, Blue Cross Blue Shield of Illinois said Hypec was experimental. But here's what the American Society of Clinical Oncology says. Hypec is no longer considered experimental. It has crossed the threshold into widely available treatments. But not for the Pike family, whose surgeon appealed, only to be denied. At one point, the mother of three took to TikTok with her guitar, hoping someone might be able to help them. Surgery was only $42,000. They put a price tag on my husband's life, and they decided he wasn't worth $42,000. How desperate did you feel in those moments? It doesn't get more desperate than opening up your guitar case and standing in front of a hospital in 100-degree weather in Houston. He never got the treatment. Instead, his cancer spread. And roughly a year after his diagnosis, Tracy Pike died at the age of 46. Are you left wondering what would have happened if he had gotten that procedure? There are definitely a lot of days where I've thought about that. In a 2022 survey, clinical oncology professionals were asked about the effect health insurance authorization had on patient care. Eighty-seven percent said they resulted in denials of therapy. Eighty percent said they resulted in disease progression. Thirty-six percent said they resulted in patient death. Blue Cross and Blue Shield of Illinois, Pike's insurance company, declined to comment on her husband's case, adding, we are committed to increasing access to safe, appropriate and effective health care based on the best available information and research. Sue's insurer, Cigna, tells NBC News, we strive to do our best to ensure that each person gets the appropriate care as quickly and easily as possible. We fell short for Ms. Sue. Cigna contacted Sue after NBC News reached out to the company for comment on our story. Sue did ultimately get that PET scan this fall, she says, but only after her employer paid for it out of pocket. Your health is in the hands of an insurance company. Do you feel like they care about your well-being? No, I don't think so. As a result of me fighting for that PET scan, I found out that I have metastasis to my liver. The screening that had been delayed confirmed her worst fears. Her cancer has returned. Stephanie Gosk, NBC News, New York. Thanks for watching. Stay updated about breaking news and top stories on the NBC News app or follow us on social media.