Kendra's Story

What can a struggling patient do when their health insurance inexplicably denies a procedure they're depending on to get their life back? 

This was Kendra's reality — a journey of resilience, hope, and ultimately, triumph. In her journey, civil legal aid played a key role. 

Challenge and Hope

At just 24, Kendra's life was already dramatically altered by Multiple Sclerosis. Walking with a cane, battling constant migraines, struggling to swallow — her days were a constant challenge. Hope emerged in the form of a potential stem cell transplant, recommended by her care team at Froedtert Hospital in Milwaukee.

The Roadblock

But what should have been a straightforward medical decision turned into a year-long nightmare. After completing all pre-transplant preparations, including chemotherapy, Kendra faced a crushing blow: her transplant was denied. Medicaid claimed the procedure was "experimental." Kendra’s doctors at Froedtert provided a mountain of evidence to the contrary, but Medicaid did not budge.  

"The denial was a huge setback," Kendra recalled. "They had covered all of the preparation, and then just pulled the rug out from under me. Not only could I not get the transplant I needed, but I had to stay in a really bad medical condition while I sorted it out."

The Battle for Treatment

Convincing Medicaid to change its mind about the nature of a health procedure is, unfortunately, not an easy thing for most individuals to achieve, no matter how important it is. So Kendra reached out to two organizations that specialize in the intersection of law and medicine: ABC for Health and Disability Rights Wisconsin. 

The team fought back, through appeal after appeal. 

This fight wasn't just about a medical procedure. It was about Kendra's future, her ability to live — not just survive. She remained immunocompromised, trapped in a medical limbo, while advocates worked tirelessly on her behalf. "People aren’t supposed to be in that pre-transplant condition for very long," Kendra observed.

A Breakthrough That Changed Everything

Finally, in early 2024, after a year of persistence on the part of Kendra and her advocates, Medicaid finally agreed to cover the stem cell transplant. The transformation was immediate and profound.

"The difference is night and day!" Kendra exclaimed. "I can take my dog for walks, watch my siblings play sports, garden, and go out on the boat with my family."

The Bigger Picture

Stories like Kendra’s are more common than they should be, and they reveal a critical truth about our healthcare system. Medical expertise is only part of the equation. Insurance denials — especially unjustified ones — can be devastating barriers to essential treatment.

How would most patients address an unjustified insurance denial without professional legal support? 

"I don't know how normal people are supposed to advocate by themselves in this system," Kendra observed. "Even with multiple lawyers, it took a year of fighting to get this right."

Every patient deserves a fighting chance. Kendra found hers with the help of civil legal aid from ABC for Health and Disability Rights Wisconsin. We'd like to see similar support available whenever a patient's well-being is threatened by legalistic complexities.  

You can hear Kendra and her mother describe the experience in their own words in this video.