WEST PALM BEACH, Fla. — A 36-year-old West Palm Beach man battling an aggressive brain tumor was denied insurance coverage for the surgery he needed to remove it — only to see his insurer reverse course in a dramatic turn that unfolded inside his hospital room while our team was there interviewing him about the denial.
WATCH BELOW: 'I don't think I could have done it on my own,' Broqsten Bunt tells Investigative Reporter Katie LaGrone
Broqsten Bunt, who goes by "Broxley," is a childhood leukemia survivor. He was recently diagnosed with a meningioma — a common, slow-growing tumor that forms inside the skull. Left untreated, the condition can lead to seizures, permanent speech impairment, cognitive issues and worse.
"Could it kill you?" asked Investigative Reporter Katie LaGrone.
"Yes, absolutely," Bunt said from his hospital room a few days after his surgery.
Doctors believe Bunt's tumor is connected to the total body radiation therapy he received as a child to treat his leukemia — a condition the medical research community calls radiation-induced meningioma.
"It can be," Bunt said, when asked whether brain tumors are something he will face for the rest of his life.
Bunt's neurosurgeon near his home on Florida's East Coast referred him to Tampa General Hospital and a specific neurosurgeon there, saying his case exceeded their local capabilities.
"He looked at the imaging and said, “This is beyond our facilities and my expertise. You need Tampa General Hospital,'" Bunt said. "The network was specifically recommended, and a specific neurosurgeon was recommended to me."
While Tampa General Hospital is in-network with Bunt's insurer, Florida Blue, his surgeon is not. In an appeal denial letter sent the Saturday before his Monday morning surgery, Florida Blue stated, it "still can't approve additional coverage or payment for out of network care," adding that "out of network care is only covered when there are no network providers available."
For months, Bunt said he had been trying to manage his need for surgery with the complex, complicated and confusing system of insurance.
"I'm taking calls from the insurance side, I'm taking calls from the medical office side, and I'm like, I don't write the bills, I don't pay the bills. Why are you calling me? Call each other, figure it out,” he said.
For Bunt, there was no way he could afford the surgery without coverage from his insurance company.
"I should not be worried about this," he said. “It’s exhausting,” he said.
Disheartened by his insurer's response, Bunt took his story to social media hoping to bring awareness to medical insurance denials. He posted a video to YouTube explaining his situation.
His wife also posted about it on TikTok. She even mailed our newsroom desperate for help.
Dr. Bill Hennessey of Health Freedom describes himself as an insider's insider. He’s a doctor by trade who became so frustrated with medical insurance companies that he now works on behalf of patients, helping them negotiate down medical bills and appeal denied claims.
Hennessey said Bunt's out-of-network denial should not have happened, pointing to the federal No Surprises Act, which protects patients from being charged out-of-network costs when they receive care at in-network facilities.
"That's what I call in the industry bad faith," Hennessey said. "That's intentionally not paying for care that is medically needed."
But Bunt’s situation took an unexpected turn when we visited him in his hospital room just days after his surgery — during which doctors removed the tumor and left him with 57 staples in his head.
"I actually do have an update," said a spokesperson with Tampa General Hospital who paused our interview with Bunt to read this statement she received while we were there.
"TGH's leadership partnered in working alongside the leadership at Florida Blue and they have agreed to cover all preoperative workup, the surgeries and the hospital admission. Post operative care is also covered."
"That's amazing," Bunt said in response to hearing the update.
"The whole thing is covered?" Investigative Reporter LaGrone asked.
"Everything I just read is covered," the spokesperson confirmed.
"Thank you … thank you," Bunt said while getting emotional.
In a follow-up email, neither Tampa General Hospital nor Florida Blue explained what prompted the reversal. Florida Blue sent Reporter LaGrone the following statement:
“We know healthcare can be frustrating and stressful to navigate and are committed to listening and working toward solutions that make things easier. We have an appeals process for members, and we partner with doctors and hospitals to best support those we serve. We're pleased when we reach positive outcomes for our members.”
Florida Blue also said the company cannot speak about individual cases. When asked whether the outcome should have required media involvement, Bunt reflected on the road it took him to get there.
"I think it takes awareness of special cases, and this was a special case," Bunt said. "I don't think I could have done it on my own."
Bunt's case is part of LaGrone's ongoing Patient No More series, which examines how and why patients gets denied insurance coverage for treatments and surgeries that come recommended by their doctors or determined to be medically necessary.
If you are dealing with an insurance denial for medically necessary treatment, leave a comment for Investigative Reporter Katie LaGrone here.