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Hilary Swank is suing a union health plan over issues she said she faced stemming from coverage for women’s health issues.
In a lawsuit filed to California federal court Tuesday, the actress, 46, revealed she has suffered from recurrent malignant ovarian cysts for more than 11 years. According to the court documents, she is suing the SAG-AFTRA Health Plan Board of Trustees after they denied her insurance benefits for the treatment of ovarian cysts and endometriosis, citing an exclusion in the plan for “infertility treatment.”
“Despite Swank’s, and her board-certified doctors’, insistence that she was not seeking coverage for fertility treatment, but only for treatment for her ovarian cysts, the Trustees dug in their heels,” the documents read. “The Trustees repeatedly said that there was no medically necessary reason to treat or monitor ovarian cysts other than for ‘infertility treatment.’ “
The union’s health plan pushed back late Wednesday.
“Contrary to Ms. Swank’s claim, the SAG-AFTRA Health Plan does cover diagnosis and treatment of endometriosis and ovarian cysts when medically necessary,” read a statement from the SAG-AFTRA Health Plan, sent to USA TODAY by compliance officer Amanda Bernard.
The statement continued, saying that “in accordance with federal law, the Plan offers a robust appeals process that culminates in the claimant’s right to a final review by an Independent Review Organization (IRO) if benefits are denied because they are determined not to be medically necessary.”
The SAG-AFTRA Health Plan said the independent review “reached the same conclusion as the Plan’s Trustees that the services were not medically necessary in this case.”
In a statement to USA TODAY Wednesday, Swank expanded on her decision to sue.
“SAG / AFTRA Healthplan (sic) claim they treat and protect all of their members equally. I don’t believe this is true,” she wrote in a lengthy statement. “If you’re a woman suffering from female health issues, I have no doubt you’ll agree with me. If you’re a man, ask your mother, your daughter, your sister, or a girl friend. I already know the answer. I’m suing SAG / AFTRA Healthplan. It’s time we are treated fairly.”
She added that she’s “truly exhausted by the way women’s ovarian and cyclical health issues continue to be treated by healthcare insurance companies.”
“I have experienced it in my own life, and I continually read about it across social media and in the press. Their policies are antiquated, barbaric and primarily view the role of women’s organs solely as a means for procreation,” she continued. “My hope is to create change for all [women] suffering from women’s health issues that have to battle with insurance companies who diminish the significance of their problems, don’t believe the patient (or their doctor’s) explanations surrounding their suffering, and severely preclude coverage to only incredibly limited services and procedures.”
The SAG-AFTRA Health Plan said in their statement Wednesday that “the Health Plan Trustees care deeply about our participants’ health and well-being as well as their privacy and therefore we are unable to comment beyond the statements that have been made public in Ms. Swank’s complaint.”
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