A 50-year-old personal trainer and his wife, a physician in Plains, Mont., are struggling to afford a hospital bill totaling more than half a million dollars after insurance failed to help cover the man’s critical 14-week dialysis treatment, NBC News reports.
Sovereign Valentine was admitted to a local Montana hospital for CKD after weeks of feeling run-down and repeat episodes of vomiting, NBC reported July 25. When he was told he was in kidney failure and would need outpatient dialysis three times a week, Valentine and his wife, Jessica, opted for care at a Fresenius Kidney Care clinic in Missoula.
Fresenius was out-of-network for the Valentines, but Jessica was told by an insurance case manager there were no in-network dialysis clinics in Montana, limiting their options. In the end, Valentine’s insurer paid $16,241.72 for 14 weeks of treatment; he and his wife were hit with the remaining $540,814.90.
According to NBC, Fresenius is one of two companies—the other being rival DaVita—that control around 70% of the U.S. dialysis market. Together the companies form a “duopoly,” meaning they can charge extraordinarily high prices for their live-saving treatments.
Medicare is a far more affordable option for dialysis, paying on average $235 per session (Fresenius billed the Valentines $13,867.74 per session). But end-stage renal disease patients like Valentine, who are under 65 years old, can only join Medicare after a 90-day waiting period.
“To me, it’s so outrageous that I just have to laugh,” Valentine told NBC.
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After graduating from Indiana University-Bloomington with a bachelor’s in journalism, Anicka joined TriMed’s Chicago team in 2017 covering cardiology. Close to her heart is long-form journalism, Pilot G-2 pens, dark chocolate and her dog Harper Lee.