Just imagine the nightmare. As you fight for your life, you're also fighting your insurance company. You have a medical procedure that saves your life. And then the insurance company you faithfully pay your premiums to says that procedure is not covered.

Investigative reporter John Mercure discovered, that's what happened to one woman.

Donna Johnson Walker had radiation to treat her cancer. Her insurance company told her she didn't have to pay.
As she laid in the hospital fighting for her life, that insurance company told Donna "Sorry, we're not paying".
Her husband was stunned at how much the insurance company ordered them to pay.

The insurance company, one of America's largest, claims Donna's treatment was experimental. Donna's doctors say that's not true.

"To say it's experimental means to me they're just not in touch," Dr. Beth Erickson told us.

It's a lesson for all of us about how health insurance works, and why, when we need it most, it sometimes fails us.

"It's just not right. It's not fair. Low down and dirty," is how Donna feels about it.

38-year old Donna Johnson has had more medical problems than most people will have their entire life. Lupus, a kidney transplant, two heart attacks,
open heart surgery, and then 18 months ago, cancer.

Donna's husband Lyndon says it's been a nightmare. "It's rough. I wouldn't want anyone else to go through it. Just because it's not how life was supposed to be."

But Donna and Lyndon feel fortunate. They live near one of America's top hospitals, Froedtert. It has some of the best oncologists in the world. Donna's prognosis got even better when she learned that pinpoint radiation, called IMRT, might knock out her tumor while preserving the transplanted kidney. The treatment saved her life.

"It was essential. I wouldn't have treated her with traditional radiation," Dr. Erickson said.

The IMRT worked. Donna's tumor disappeared, her kidney was saved, and life seemed to be looking up. Until Donna's insurance company, Aetna, got involved.

"They told me it was going to be handled and taken care of... Then they send me a letter and stress me to the nth degree again...bout a $30,000 bill and that I have to pay it."

That's right. Aetna. One of the country's largest insurers, with 15 million members and $25 billion in annual revenue, changed its mind.. and billed donna the full $30,000 for her life saving radiation.

$30,000 she was expected to pay out of pocket...
After Aetna originally told her it was covered.

"It's underhanded and unethical to me. They should cover it," Donna says.

Lyndon agrees. "You're sold the pipedream. You get the insurance and you really dont have to worry about much. Obviously we know that's not the case now."

Tim Waldoch is Froedtert's Assistant Vice President of managed care. He says it's surprising and frustrating.

What makes it so surprising? Every other insurer we could find would have covered Donna's treatment.
Humana, WPS, United Healthcare, Cigna, Touchpoint, even Medicare pays up.

"It hurts to see your child or someone you love that you know has gone thru hell and back," Donna's mom says.

So why won't Aetna pay for Donna's treatment? The big east coast company claims that IMRT is experimental.

Dr. Erickson doesn't agree. "There's more and more data to suggest that it's very effective. To view it still as experimental means that they're not in touch with the passage of time and the data that's out there to suggest it should be considered standard with many patients."

Froedtert deals with dozens of insurance companies. Aetna is about 15th on the list in terms of volume they do here. But they're #1 when it comes to denying payment for legitimate medical purposes.

"Aetna is an outlyer here. They are not covering the same type of things that other insurance companies or Medicare covering. Thats why we find oursleves in this situation that we do today," Tim Waldoch agrees.

Donna called Aetna repeatedly. She got nowhere. Recently we called and told Aetna they were the subject of this story.

So they paid Donna's claim.

Good for Donna, but we've learned there are at least six other patients here in milwaukee that received the same life saving treatment as Donna that Aetna won't cover.
Again Aetna is refusing to pay.

"They should cover it. It's lifesaving for a lot of people," Donna says.

Aetna says they only paid for Donna because they miscommunicated with her initially.
As for those other six area patients saved by IMRT?
Aetna still says they wont pay...Meaning those patients continue to fight for their lives while battling the insurance giant.

Our volunteer consumer support network here at the station, Call for Action, did a lot of very hard work on this story.