Home NewsShe got a heart transplant at 11. Then, her insurance declined to cover medication she says keeps her alive

She got a heart transplant at 11. Then, her insurance declined to cover medication she says keeps her alive

by Keith BieryGolick
0 comments
She got a heart transplant at 11. then, her insurance

“Can you hear it?”

The stuffed animal is making a sound. It’s the sound of her son’s heartbeat. He died in 2012.

At Gate of Heaven Cemetery, the sun is setting. Cutter’s son is buried there.

Payton Herres hasn’t been in a while, but she knows exactly where to go. At the marker, Herres takes a picture.

And then she sends it to Cutter.

“I always wonder if he’s proud of me. I hope Mary is proud of me,” Herres said. “I don’t want to let them down.”

Herres was born with a rare congenital heart defect that required two surgeries before she turned 11. Neither worked.

“The doctors basically told my parents you need to start planning a funeral,” Herres said. “I was in really bad shape.”

But when Cutter’s son, Christian, died, his heart gave Herres a new shot at life.

All these years later, Herres and Cutter are about to meet for the first time. Sitting at her dining room table, Cutter wipes her eyes.

“I’ve been crying all day,” Cutter said.

Because to keep her heart beating, Herres tells me she needs a medication called everolimus, it helps stop her body from rejecting the transplant. And earlier this year, her insurance company refused to cover it.

They said it wasn’t medically necessary. But Herres tells me she would die without it.

“I almost ran out of pills,” Herres said.

Eventually, after months of denials and appeals, Herres’ insurance agreed to cover the medication. A spokeswoman for Anthem Blue Cross and Blue Shield said the company didn’t consider Herres’ previous treatment in its initial decision.

“We apologize for the frustration this caused her,” the spokeswoman said.

But even with the medication approved, Herres tells me the price increased dramatically. Something that almost puts her right back where she was when she was fighting with insurance in the first place.

Something that brings back all kinds of memories for Cutter.

“It’s like losing him again,” Cutter said of her son. “It’s just not right.”

At her dining room table, Cutter looks through old photos of her son, playing football, hugging his dog, standing with her at the pool.

Outside, it’s dark now. Herres almost slips while walking up the driveway. She’s carrying a binder full of documents showing those battles with insurance.

Cutter waves.

“Give me a hug,” Cutter said. “You’re special to me.”

It’s why she offered to pay for the medication, even when insurance wouldn’t.

“I just want her to be OK,” Cutter said. “For him, and for her.”

news source

You may also like

Welcome to Daily Transplant News, your trusted source for the latest updates, stories, and information on transplantation and organ donations. We are passionate about sharing the inspiring journeys, groundbreaking research, and invaluable resources surrounding the world of transplantation.

Most Viewed Articles

Latest Articles

Copyright ©️ 2025 Daily Transplant News | All rights reserved.

Are you sure want to unlock this post?
Unlock left : 0
Are you sure want to cancel subscription?
Show/Hide Player
-
00:00
00:00
Update Required Flash plugin
-
00:00
00:00