Insurance Says We Owe $51,562.45 after Heart Surgery
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I have had many check-ins and emails about my son, Caden, since his most recent open heart surgery. I wanted to take a few moments to update you on his health, his outlook, and his current insurance woes. Grab a cup of coffee and let’s catch up!
Health Update & Insurance Fiasco
I figured it’s well past time for an update on how my oldest son, Caden, is doing since his most recent open heart surgery. The short story is that he’s doing great and almost completely back to his regular self. He is amazing!
The long story is that we are, yet again, starting the process of fighting with insurance to cover what surely went through a rigorous and routine pre-approval process the hospital performs before such a large operation was undertaken.
This was Caden’s FOURTH open heart surgery (read more on his early years here)… so this is not our first rodeo. I really didn’t want this update to turn into a rant on our broken healthcare system, but alas… here I am.
As a self-employed person in the USA I pay out the nose for healthcare premiums for me and my two boys. Because Caden has more than one health condition that requires frequent monitoring, I have always made sure that the plan and coverage we have is on the higher end of the options available to us. I opt to pay a little more on the premiums for overall better coverage knowing that he has many, many doctors appointments and prescriptions filled throughout the year. (So far this year alone he has had 141 claims!)
As I said earlier, first and most importantly… Caden is doing great.
But now for the ensuing insurance battle…
Grand total billed to insurance for Caden’s healthcare and treatment so far in 2026:
$961,956.32
Insurance says he owes:
$51,562.45
Here’s what happened:
Caden underwent his fourth open heart surgery on April 16th, 2026. He went for pre-admission on April 15th and ALL fifteen of the pre-admission tests in that claim have since been denied. This included the lab testing, ultrasounds of his neck and heart, X-rays, blood typing, blood grouping, urinalysis… ALL of it. The entire day was denied:
He had his actual surgery on April 16th, which lasted a whopping 16 hours – until almost 2 am!
During this surgery they… slimmed down his aorta and gave him a mechanical aortic valve, they swapped out the conduit in his heart for a larger one (one that had been in place since August 2015), and they worked on his coronary arteries. This is what the claims submitted to insurance actually say:
-Repair of ascending aorta with graft on heart-lung machine with aortic root replacement and heart reconstruction.
-Repair of congenital defect in right or left heart chamber.
-Coronary artery bypass or valve procedure reoperation more than 1 month after original operation.
All three of these claims from the surgeon have also been denied:
In fact, 46 of the 141 claims Caden has had submitted so far in 2026 with Blue Cross Blue Shield of Kansas have been denied.
That means that over ONE THIRD of his claims this year have been denied by Blue Cross Blue Shield of Kansas.
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Caden now has a mechanical heart valve. Because of this, he is on daily blood thinner medication and needs frequent monitoring to make sure he stays in the desired range. After weeks and weeks of going to MANY lab appointments, he now has a home INR machine (it looks similar to a blood glucose monitor for diabetes) to check his levels. He is also back on his regular medication schedule. The $890 claim for the home health nurse that they insisted come to our home to deliver the machine and to teach us how to use it – has been denied by insurance:
Post-Surgery Cardiology Checkup Appointments
Since his surgery, Caden has had three follow-up appointments with his cardiologist at the hospital’s satellite office here in Wichita. One at the beginning of May (just days after coming home) one toward the middle/end of May, and one at the end of June.
All three of those insurance claims have since been denied by Blue Cross Blue Shield of Kansas.
In fact, he has another update with this cardiologist in Wichita tomorrow.
I can’t wait to see that this claim, too, has been denied.
***sigh***
I have printed everything out to talk with them tomorrow and to see if the claims need to be submitted a different way. The team here in the Wichita office is always amazing. They know Caden by name, they love to see his face come walking through the doors, and they go out of their way to make the visits as pleasant as can be. Everyone always says that Caden is one of their favorite patients! ♥ It’s going to be so bittersweet when he is released to the adult care team at a different hospital. Hopefully they hang on to him a while longer yet!
I’m sorry for turning this into a grocery list of the failures of insurance, but Blue Cross and Blue Shield of Kansas has taken over $12,000 of my money so far this year in premiums alone. I don’t know how much of a contractual agreement there is between Children’s Mercy and Blue Cross, but my 19 year old son should not be on the hook for over $50,000. This should not ruin his finances for his adult life and he should not have to jump through hoops to get things paid.
That’s all.
Oh! I almost forgot one important part…
Caden has been struggling to find a job since he came home from the hospital. He’s put in plenty of applications but so far nothing has worked out.
I’ve been discussing the idea of him beginning to write and/or create video content about his experiences with his heart condition, heart surgeries, medical issues in general, and possibly his mental health as well.
I haven’t disclosed much about Caden’s mental health journey because he previously asked me not to, and I will continue to honor that until he tells me otherwise. I will say, however, that as his mother I felt blind and desperate at times, and I can absolutely see a need for his particular voice and his experiences in today’s world.
He has started writing a bit of his experiences to hopefully share as blog posts on the “Heart” section of Heart Hook Home when he is ready. I am encouraging him to continue opening himself up to sharing what its like to live with his condition, what it’s like to loudly tick like a clock 24/7 (with the mechanical heart valve), how he copes with his mental health diagnosis, and more in video format.
What are some questions you would have for Caden? I’ll make sure to pass them on!
Thank you all for your continued prayers. I hope to announce a new author/helper soon! Afterall… he’s got to pay for all those medical bills! 😵💫
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