Responds: Woman Fights Insurance to Cover Dad’s Recovery

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Maria Pinzon says what seemed like a minor fall for her dad has put her whole family in jeopardy.

“My father was a completely independent guy,” said Pinzon. She describes life with her 93-year old dad, Luis,before the accident as a breeze. “He used to clean house, he used to do laundry by himself and do everything by himself,” said Pinzon. But then she got the bad news from the hospital.

“He had a fracture on his neck,” said Pinzon.

That injury has meant long hours for Pinzon — not just taking care of Luis but fighting to get the care and supplies he needs for his recovery .

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“I’m the only one that works and I haven’t been able to work,” said Pinzon, “It’s been a complete disaster.”

A disaster not just because of the fall but because of what she says happened after his injuries. Luis spent three weeks in the hospital and continued his recovery in a rehabilitation center. Maria says she was suddenly told her father’s insurance would no longer cover his stay.

“He couldn’t even stand by himself,” said Pinzon. She took her father home even though she didn’t think he should be there.

“I have to take a bath for him. I have to dress him. I have to take him to the bathroom,” said Pinzon.

Then she tried for months to get insurance to help with his care — even a wheelchair to replace the one they borrowed from the rehab center. She says she’s called her dad’s insurance company repeatedly asking for equipment and therapy but got no results.

“It’s very frustrating and it takes all your energy and it drains you every time,” she said. “You have to be on hold for an hour, an hour and a half two hours.”

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Pinzon says she finally decided to she call the Telemundo 51 Responde-NBC6 Responds Team.

“I know they help people and are able to resolve cases,”said Pinzon.

Consumer specialist, Luz Sanchez, was able to get Pinzon and the insurance company on a conference call.

“We are talking to them on the phone I am receiving a call from them and they’re telling me we are going to take care of you,” said Pinzon.

Insurance company, Ambetter, then approved a therapist for her dad as well as a neck brace, a walker and even a new wheelchair.

“I received the wheelchair the next day, next day,” said Pinzon

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Ambetter did not comment to us about what led to the change. But Pinzon says she’s grateful for what they’ve provided.

She says her dad’s doctor signed off on him being released from the rehab center and now she’s working to get him readmitted until he can stand on his own.

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