Orlando couple put their wedding on hold after his stroke — now they're paying $60K out of pocket for his rehab because insurance said no, twice

“We got engaged before this, and we put off our wedding for this,” Gonzalez told WFTV9.

Now, instead of planning a wedding, the couple is fighting their insurance company and paying out of pocket for his rehabilitation.

The insurance denials

Gonzalez’s United Healthcare plan covers up to 120 days of inpatient care, WFTV9 reports. But as Hill quickly discovered, having those days doesn’t automatically mean getting them — each requires individual approval.

After returning home to Orlando from inpatient rehab in Jacksonville, Gonzalez wound up in the emergency room and was approved for another inpatient stay at Advent Health in Winter Park, where the couple felt he was improving. But that coverage got cut off.

The reason stated: he wasn’t making “enough functional progress,” or “notable continued progress in therapy.” When Hill asked the insurer to define what that progress would look like, she didn’t get an answer.

The denial also came despite a letter from Gonzalez’s neurosurgeon stating he had “demonstrated encouraging signs of recovery” and required “daily physician oversight,” and that “premature discharge to a lower level of care would place Tayler at significant risk.”

A formal appeal filed a week later was denied on the grounds that continued inpatient care was “not medically needed.” Another request, filed in June, was also denied.

After WFTV9 brought the case to United Healthcare’s attention, the organization said, “We empathize with Mr. Gonzalez and his family during this challenging time, and we wish him continued recovery and health. Based on a thorough review of the clinical information submitted by his doctors, coverage decisions for both acute inpatient rehabilitation stays were determined to be appropriate. We remain available to help address any future coverage questions and review options.”