Two years ago, Paul Chappell was diagnosed with a rare brain tumor.
Now, he’s at risk of losing the insurance and care that has kept him alive.
One morning in December 2022, Paul woke up to go to work like any other day. Little did he and his family know that the struggles he faced that morning would change the course of their lives.
“When he woke up, he was having problems getting up out of bed and his speech started to slur, so we took him to Weirton Medical, and that’s when they found out that he had a 5-centimeter tumor the size of a lime,” said Pam Chappell, Paul’s wife.
The diagnosis? Paul has a glioblastoma multiforme, or a GBM, the most aggressive primary brain tumor in adults, with an average survival rate for 10 years at under 1 percent.
Now, 2 years later and after several treatments, Paul has begun to have stable scans. However, another problem is beginning to befall the Chappells — insurance coverage.
“Unfortunately, as of December 31, Paul will lose his insurance due to the COBRA rule of 18 months,” Pam said. “And so, I reached out to Social Security, I reached out to Medicare, being that this is terminal.”
However, Pam was quick to find that Social Security or Medicare might not be able to help.
“When I called Social Security, and I called Medicare, they said being that Paul is 63 years old that he would not qualify because of the 65-year-rule,” Pam said.
“I asked if there could be an exception, and they said the only way that an exception could happen is if he had ALS, or if he had end-stage renal failure. They would not grant it for a GBM brain tumor.”
Pam also reached out to Representative Guy Reschenthaler (R-Pa. 14th District), as well as other agencies, but most were unable to provide the help she was looking for.
If Pam and Paul cannot find coverage, they could be forced to spend at least $24,000 a month on the treatment — known as Optune — that has kept his brain scans steady.
Now, with the clock winding down on finding coverage, the Chappells look to the future with uncertainty.
“Right now, Paul is at the mercy of the federal government to wave this,” Pam said. “That’s what this boils down to.
“It’s bad enough that you worry about him all the time. Is he OK, is he OK? But to worry about insurance, it’s just not right.”
NEWS9 reached out to the Social Security Administration in Washington County, as well as the Federal Social Security Office, which declined to comment.
Reschenthaler’s Office responded to the Chappells, saying they would advocate for the couple, and the Center for Medicare & Medicaid Services said they’re sending Paul’s info to the Philadelphia Social Security branch.
