JACKSONVILLE, Fla. – A Fort Myers father now finds himself in the fight for his life. Only a few months after Zach Rizutto and his wife welcomed their baby, he was diagnosed with brain cancer.
The couple thought they could handle it all. Then their insurance company denied Rizutto's claim for the potentially life-saving cancer treatment his doctor recommended.
"I want my husband to live and be here for our child," said Melissa Rizutto, Zach's wife.
The Rizuttos said that news cast a cloud over everything in their lives, from the birth of Roxanne to the cancer diagnosis itself. The last thing they expected was a fight their insurance provider.
"We thought we'd spend this first year learning the ins and outs of being a parent, but instead we spent this first year learning the ins and outs of fighting insurance companies," Melissa Rizutto said.
The treatment recommended by Rizutto's physician is proton beam radiation. It's less invasive than traditional methods, targeting specific cancer cells and leaving healthy tissue alone. It costs $125,000.
Patients travel from all over the world to get the treatment at UF Health Proton Therapy Institute in Jacksonville, one of three cities in Florida with facilities that offer it.
"Having less radiation in your brain means less chance that more tumors can grow," said Melissa Rizutto. "The quicker we get it, the better chance we have of having a better quality of life."
United Healthcare denied Rizutto's claim, saying that proton therapy "is not more effective than standard treatment for this type of brain tumor," citing independent clinical evidence.
"Please look at my doctor's recommendations, please care about my quality of life and my family," Zach Rizutto said.
Dr. Robert Lustig is the radiation oncologist treating Rizutto at the University of Pennsylvania. He said the standard treatment mentioned by the insurance puts his patient at risk for serious side effects.
"The insurance company is saying, 'The best is not what we approved. You're getting good enough," said Lustig.
Lustig, who has spent hours on the phone with the couple, said he's advocated for Rizutto and written letters on his behalf imploring the insurers to consider proton therapy. His opinion fell on deaf ears.
"None of this has to do with improving patient care," he said. "It all has to do with dealing with the insurance companies."
Rizutto is not alone in his plight.
Stuart Klein, executive director of the UF Health Proton Therapy Institute, estimated 60-70 percent of patients with varying types of cancer cannot get their insurance companies to pay for the treatment.
"We go through multiple appeals," said Klein. "Some of it has even gone as far as taking classes to administrative law judges."
That's what a Seattle father with brain cancer had to do. Ronnie Castro took his insurer to court when the company denied his claim. They settled out of court, and now Castro's cancer is in remission.
The Rizuttos are spreading the word about their situation in the hopes they can achieve the same outcome -- without going to court.
"I'm hoping to continue my healthy life and spend as much time with my beautiful family and friend and everyone else out there," said Zachary Rizutto.
In lieu of a legal battle, the Rizuttos set up a GoFundMe page to raise money from friends and family. It took less than two months to raise enough to begin proton treatment at the University of Pennsylvania.
In that regard, they're more fortunate than others. Lustig said most patients cannot afford proton therapy on their own and instead go with the standard radiation treatment, despite the risks.
Lustig said patients really need to take a close look at their insurance policies to see what it may or may not include. He said people should consider paying more for a different plan with better coverage.
To learn more about Rizutto's progress or to donate to his cause, just visit the family's GoFundMe.