Skip to Content Skip to Footer

cancer

This 7-Year-Old’s Chemo Medication Isn’t Being Covered By Insurance

cancer

Maddison Mertz, a gymnastics fan and typical 7-year-old, began experiencing a stiff neck, tingling in her arm, headaches and vomiting in late 2016. After a doctor’s visit, she was diagnosed with a tumor inside her spinal cord and Stage IV cancer.

Thus began Maddison’s battle with cancer. She underwent surgery to remove about 95% of the tumor before she had radiation therapy. Now, however, she needs targeted chemotherapy drugs as part of her treatment, because without it, her cancer could return. The horrible part about all of this is the fact that her medications aren’t being approved by her parents’ insurance, as her dad, Zach Mertz, told CBS affiliate WCCO:

“At first I thought it will get approved because things get approved and the hospital was taking care of it and the first one was denied. And OK we’ll go through a second denial. And the second was denied and they used a word: investigational.”

Mertz told Babble that “the drugs that match her type of cancer and are FDA-approved will not work on her.” Why? Her type of cancer, Glioblastoma multiforme, is rare in kids. Thus, all of the approved medications were tested on adults, not kids. Genetic testing has shown that the approved drug will not work for Maddison’s specific tumor, but that the drugs being denied to her would help.

Walt Cherniak, a spokesperson for the family’s insurance company Aetna released a statement as to why the drugs aren’t being covered:

“This is a very difficult situation, and Aetna is very sympathetic to the Mertz family. Based on the most recent studies, the requested medications are experimental and investigational for treating this type of disease. We are working with the family and the treating physicians to help them assess their next steps.”

Their doctor, Dr. Bendel at Children’s Hospital and Clinics Minnesota, is trying to find a way to help Maddison, telling WCCO:

“One would be to say OK we do surgery, radiation and then and that’s all we have to offer. The other option is to say maybe there’s something out there that will work that we don’t have the proof that it will work but at least it gives us hope.”

Part of the problem with the fact that their insurance isn’t covering the chemotherapy drugs is the simple fact that they cost $20,000 a month–which is unaffordable for the Mertzes. As a result, the Mertz family are paying out of pocket for the treatment, because it’s their daughter, and naturally, they would do anything to save her life–as any parent would for their child. Mertz knows this only too well, stating:

“Health cost can drag people into bankruptcy but you don’t want the hindsight of I should’ve, could’ve. You just do it. So we’ll do everything we can right now. I only have one focus right now in life.”

The Mertz family created a GoFundMe page for Maddison. If you are able, please consider donating to help fund Maddison’s treatment. Right now, they are at 150k out of a 300k goal.

Skip to Banner / Top Skip to Content