Hillary Swank sues SAG-AFTRA Health Plan over denial of coverage for ovarian cysts treatments

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Source: Hillary Swank/Twitter

Actress Hillary Swank filed a lawsuit against the Board of Trustees of the Screen Actors Guild – American Federation of Television and Radio Artists (SAG-AFTRA) Health Plan on Tuesday.

In her complaint, Swank alleged that the SAG-AFTRA Health PlanTrustees unfairly denied her claim for insurance benefits for “medically necessary treatment for ovarian cysts and endometriosis.”

Hillary Swank is suffering from recurrent malignant ovarian cysts

Hillary Swank has been suffering from recurrent malignant ovarian cysts, which was diagnosed in 2008. That year, she underwent emergency surgery to remove her damaged left ovary.

Since the surgery, her doctors required her to undergo aspirations of the cysts—sometimes multiple times a year—because her ovarian cysts develop rapidly and destructive.

In 2009, Hillary Swank started submitting claims for treatments of her ovarian cysts. Her claims were initially denied. The SAG-AFTRA Health Plan cited an exclusion of “infertility treatment.”  In 2011, it eventually agreed to cover all costs for her ovarian cysts treatments based on the fact that she was not trying to conceive.

At the time, doctors were trying to treat her ovarian cysts with birth control pills. Since birth control pills were ineffective to treat her medical conditions. Her doctors required regular ultrasounds to monitor the growth of the ovarian cysts and surgical aspirations of the cysts as necessary.

Hillary Swan continued to submit claims for her ovarian cysts treatments, which were paid in part by the SAG-AFTRA Health Plan Trustees until 2015. Aside from ovarian cysts, Hillary Swank was also receiving treatment of her endometriosis. That year, she underwent procedures to preserve her ability to conceive in the future if she so chose. She did not submit claims for these procedures.

She continued to receive treatments for ovarian cysts and endometriosis between January 1 2017 and present and submitted claims to the SAG-AFTRA Health Plan Trustees.

Trustees think Hillary Swank’s treatments were “fertility-related”

However, the Trustees decided not to cover her treatments after January 1, 2016. They claimed that treatments were “fertility-related.”

Hillary Swank’s doctors’ are monitoring and treating her remaining ovary “to prevent the risk of debilitating medical conditions, including cancer, loss of estrogen production, premature menopause, osteoporosis, depression, hyperlipidemia (high cholesterol in the blood), coronary artery disease, arthritis, asthma, chronic obstructive pulmonary disease, chronic pain, fatigue, chest pain, heart palpitations, muscle spasms, insomnia, recurrent urinary tract and yeast infections, and even early death,” according to the lawsuit.

With their” oppressive” decision to deny coverage for her treatments, the Trustees exacerbate Hillary Swank’s medical condition. In addition to experiencing fear of not knowing when the next painful episode would occur, she is also undergoing a great amount of emotional suffering.

In other words, she is suffering emotionally, physically, and psychologically because of the Trustees repeated decision to deny coverage for the necessary treatments of her ovarian cysts and endometriosis.

Trustees allegedly completely disregarded Hillary Swanks’ real health risks

According to the lawsuit, One of Hillary Swank’s treating board-certified physician stated that she has “a very high risk of ovarian torsion and subsequent emergent surgery and potentially causing her to lose her ovary and therefore place her into early surgical menopause. . .”

He physician added, “It is my medical opinion that these periodic pelvic ultrasounds to monitor for ovarian cysts are necessary regardless of any fertility endeavors for the health of her remaining ovary. . . . If she loses her remaining ovary, she will have early onset menopause, which is associated with a myriad of medical issues that will affect her overall health and well-being for reasons beyond fertility.”

Hillary Swan alleged that the Trustees completely disregarded the real risk of losing her remaining ovary, denied her claims, and refused to pay any health benefits. Therefore, the Trustees violated the Employee Retirement Income Security Act (ERISA) and the terms of the SAG-AFTRA Health Plan.

The two-time Oscar winner stated that her lawsuit “addresses the shockingly antiquated question of whether the sole purpose of a woman and specifically her ovaries, is to procreate.”

Hillary Swank is asking the court to “clarify and enforce Swank’s past, present, and future rights to benefits” under the SAG-AFTRA Health Plan. She is also seeking a court order to obtain other equitable relief including for pre-judgment and post-judgment interest, and for attorneys’ fees and costs.

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