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<\/a><\/p>\nGonzalez would love to get out of his specialty wheelchair and walk his fianc\u00e9e, Lauren Hill, down the aisle. But as he battles a serious neurological condition, he\u2019s also had to fight his insurance company for treatment.<\/p>\n
The couple believes the inpatient therapy he was getting was really working and speeding up his recovery, but United Healthcare didn\u2019t think it was enough. It denied continued inpatient coverage because it didn\u2019t believe he was making what it called \u201cnotable continued progress.\u201d<\/p>\n
Customers claim window company took their money, never did the work<\/a><\/p>\n 32-year-old Tayler Gonzalez loves adventure; he loves to move and sweat. <\/p>\n He said, \u201cI was an avid gym goer. I was healthy at sports, jump rope.\u201d<\/p>\n When he asked the love of his life to marry him, their future couldn\u2019t be brighter, but now life is different. Each movement and each moment for Tayler is a fight. The dream of marriage and children seems more distant with a diagnosis of a debilitating spinal condition.<\/p>\n Gonzalez recalled the conversation he had with his doctor, \u201cFluid in your cervical spine and Chiari malformation. And they recommended surgery as soon as possible.\u201d<\/p>\n He said his condition worsened following a handful of surgeries, including an extensive one in February.<\/p>\n Lauren Hill said, \u201cHe had a stroke during that surgery.\u201d<\/p>\n That set him on a new path starting with inpatient rehab in Jacksonville. The couple said that meant 4-hours a day working through movements. Tayler\u2019s insurance plan with United Healthcare allows 120-days of inpatient care, but Hill quickly learned just because Gonzalez has those days, doesn\u2019t mean he gets them. They must be approved by insurance and based on what his employer covers, and they said Gonzalez was not approved for more days. After a return home, he ended up in the emergency room and was approved for more inpatient therapy at Advent Health in Winter Park where they felt he continued to improve. Despite his belief in the progress and his lifted spirits, they said that coverage ended, too.<\/p>\n Hill explained, \u201cBecause he wasn\u2019t making enough functional progress. When I asked the insurance company what that looked like, what were they looking for specifically, they couldn\u2019t give me an answer.\u201d<\/p>\n A request for coverage was denied in April for not \u201cmaking notable continued progress in therapy.\u201d A week later, their appeal was denied \u201cbecause it is not medically needed\u201d even though a neurosurgeon\u2019s letter notes he\u2019s \u201cdemonstrated encouraging signs of recovery\u201d and \u201ccontinues to require daily physician oversight\u201d and \u201cpremature discharge to a lower level of care would place Tayler at significant risk.\u201d<\/p>\n