PLATTE CITY, Mo. -- The paperwork that surrounds Mike Farris at his desk is a sign of one battle he's fighting. His other battle is against advanced carcinoid cancer which was diagnosed in 2005. Last year, when the cancer returned, doctors recommended a clinical trial of nuclear medicine in Texas.
"This is the last basically treatment option available to me at this stage," said Farris.
He and the clinic talked with his insurer, Golden Rule, before he had the first treatment in December. They understood it would be covered. In 2006, Mike, a financial planner, got a rider on his insurance policy that, under Missouri law, covers clinical trials.
"I would be nuts not to sign up for it and have been paying for it ever since," said Farris.
But Golden Rule notified him in February that it wasn't covering the treatments. The first one alone had cost $97,000.
"Uh, shock and hurt and I kept thinkin' this has gotta be a mistake," he said.
In a letter, Golden Rule told him, "The treatment is experimental/investigational as defined by the health insurance plan. Therefore, benefits are not available."
Farris responded, "If a clinical trial insurance rider doesn't cover clinical trials, then what does it cover? I haven't got an answer for that yet."
He appealed to the insurer and to the Missouri Department of Insurance which asked Golden Rule questions. Without coverage, he missed out on his second treatment. It should have been in March.
"I never would have thought this would have happened to me," said Farris,
FOX 4 contacted Golden Rule on Mike's behalf. Thursday, Mike called us in tears -- tears of joy. He said our involvement made a difference. Golden Rule told him it will pay. He hopes to have his second treatment very soon.
Golden Rule provided FOX with this statement:
"While an external medical expert concurred in our initial decision, we undertook an additional review and have made the decision to cover the costs related to this
investigational trial. We have provided coverage for Mr. Farris' treatments for
a number of years now and continue to wish him well as he fights his