Kyle, Texas — Kenney Blewett, who had been diagnosed with a lung disease over ten years ago, began experiencing severe flare-ups this year that left him struggling to breathe.
According to his wife, Cindy, these episodes were described by Blewett as “the scariest thing in the world.” Although each episode typically lasted only a few minutes, their frequency increased significantly. Everyday activities, such as taking out the trash, left him feeling exhausted, leading to him rarely leaving home and resulting in a weight loss of 45 pounds. Cindy recalled a doctor remarking, “That sounds like cancer,” emphasizing the worsening condition of her husband’s health, which had deteriorated due to years of smoking.
On June 2, Blewett’s pulmonologist prescribed a new medication aimed at alleviating the distressing symptoms associated with chronic obstructive pulmonary disease (COPD). However, the prescription was not filled right away. Two days post-appointment, he received an email from Walgreens, indicating that the medication was delayed due to an ongoing insurance issue.
“He was optimistic about the potential benefits of the medication,” Cindy reflected two months after her husband’s passing. “I wish we could have discovered its effectiveness.”
Delays and denials related to insurance claims have become a notorious aspect of the American healthcare landscape, with nearly 70% of adults identifying them as a significant concern, according to a KFF Health Tracking Poll conducted in January.
In June 2025, following a high-profile incident involving the CEO of UnitedHealthcare in New York, the Trump administration announced a widely publicized commitment by numerous major health insurers to eliminate some of the obstacles that hinder patients from accessing recommended medical care. However, this commitment was voluntary and lacked penalties for non-compliance. A report from KFF Health News in July revealed that some insurers who signed the pledge were not fully implementing the promised changes.
In light of the lack of substantial federal reforms, state lawmakers, including those in Texas, have been working to regulate the insurance industry to address delays and denials. However, the majority of health insurance plans, encompassing traditional Medicare and employer-sponsored options that cover over half of all Americans, usually fall outside state regulations.
Even medical office staff and pharmacy workers find the complex landscape of state and federal insurance regulations challenging, a situation that may become more intricate as artificial intelligence assumes a greater role in the approval and processing of insurance claims.
“It has become utterly unmanageable,” stated Matt Toresco, CEO of Archō, a patient advocacy and consulting firm. He emphasized the necessity for patients to receive more support in dealing with insurance obstacles.
The Blewetts’ experience highlights the daunting task of navigating these complexities for patients and their families. Cindy has been seeking clarification from Medicare, Kenney’s private Part D drug plan, his doctor’s office, and Walgreens regarding the medication delay. She continues to have questions about the responsibility for the delay and possible prevention measures.
Reflecting on the COPD flare-up her husband experienced on the afternoon of June 7, she questioned whether it could have been avoided and if that might have influenced his tragic decision to end his life that night.
During the first week of June, Cindy noted that Kenney frequently inquired about the status of his prescription, which was a liquid medication intended for inhalation via a nebulizer. Initially, she was not overly concerned about the delay, considering that since its acquisition by a private equity firm, Walgreens had reportedly reduced its workforce significantly, leading to slower prescription processing times.
When Cindy contacted the pharmacy a few days after Kenney’s appointment to inquire about the status of the medication, she was informed by a Walgreens employee that prior authorization was required for the prescription. Prior authorization, also known as preapproval, is a common practice among health insurers that necessitates medical providers to obtain approval before patients can receive covered treatments.
Cindy was unaware which of Kenney’s insurers required this prior authorization for the medication. Over the years, she had managed multiple insurance policies for her husband, including Medicare Parts A and B, along with a private Part D plan from Wellcare Value Script and a Medicare supplement plan from Blue Cross and Blue Shield of Texas, also known as a “Medigap” plan, which covered additional out-of-pocket expenses.
Initially, Cindy suspected that Kenney’s Part D plan had imposed the prior authorization requirement for the new medication. However, since it was a liquid inhaled through a nebulizer, it was one of the few drugs covered under Medicare Part B’s durable medical equipment benefit rather than Part D.
The Medicare agency informed Cindy that there was no record indicating that the prescription had been billed to Kenney’s Part B policy. Sarah Tanner and Myriea Amaya, representatives for Centene, the parent company of Wellcare Value Script, declined to provide comments for this article.
After Kenney’s passing, Cindy sought further clarification at the Walgreens pharmacy, where she reported receiving inconsistent information from the staff. She was told that the prescription had been submitted to Medicare Part B but lacked a necessary diagnostic code that should have been provided by the prescribing doctor.
Carmen Lopez, a spokesperson for Walgreens, communicated to KFF Health News in late September that the company…
