Feb 11, 2014 7:00 PM by Danielle Lerner

Former Marine now battling Medicare for life-saving surgery

TUCSON- A Tucson man and former Marine says his life is in limbo, caught between the need for life-saving surgery and a Medicare Advantage plan that will not cover the procedure. Robert Zurheide went on disability after he was injured in 2002 while working as a corrections officer in Florence. He has been battling chronic pancreatitis for nearly three years and says doctors at UAMC recommended a pancreas transplant as soon as possible. That was more than eight months ago.

"I love my country to the core, it's in the core of me," said Zurheide.

Military service is more than a passion for the Zurheide family, it is a way of life. Robert's son Graham is a 1st Lieutenant in the Marines and his younger son has plans to join. However it is a tradition that claimed the life of Zurheide's oldest son, 20-year-old Robert Zurheide Jr., who was killed while serving in Iraq in 2004.

"He came over, he gave me that big hug and he went back around to the car, got in and they drove off, and I never saw him again," Zurheide said.

Nearly ten years after his son's death, Zurheide says he is now fighting for his own life. He spends hours, even days in the hospital as his pancreas continues to fail.

"Worst pain I've ever felt in my life, and it could kill me," he said.

In May of 2013 Zurheide's insurance denied the transplant, citing a "non-covered benefit under patient's policy." The National Coverage Determination lists several instances where Medicare covers pancreas transplants, but only for patients with Type 1 diabetes. Zurheide has Type 2. He appealed the decision but says he never got a clear response.

"Are they waiting for me to go away? Are they waiting for me to die?" he said.

News 4 Tucson reached out to Medicare for answers and within hours, was told a caseworker had been "assigned to reach out to Mr. Zurheide and hopefully to help him."

The press officer went on to explain that, "people with Type 2 (diabetes) have a problem with insulin resistance, so getting a new pancreas, which secretes insulin, doesn't help them. However, people with Type 1 don't have the ability to produce insulin, so a new pancreas does help."

Humana also responded saying a customer service representative was now researching the case but that, "due to federal privacy laws, Humana cannot comment on the specifics of a member's concern and always works directly with the member to resolve any issues."

"I want to be here for my grandsons, both of them," Zurheide said. "I mean one of them doesn't have a father and I'd like to be around a little while."

Since News 4 Tucson got involved Zurheide has been talking with both Medicare and Humana for the first time months. However it is still not exactly clear what his options are moving forward. We filed a formal information request with Medicare but no word yet when that will go through. Stay with News 4 Tucson for more updates on this story as we learn more.


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