DAYTON — A Dayton woman was 11 when she needed a heart transplant; now she’s in her 20s and said she’s struggling to afford to keep it beating.
[DOWNLOAD: Free WHIO-TV News app for alerts as news breaks]
As reported on News Center 7 at 11:00, Payton Herres’ insurance company, Anthem Blue Cross and Blue Shield, told her that she no longer needed her anti-rejection medication.
TRENDING STORIES:
- Local taco restaurant announces sudden closure
- 16-year-old boy found shot in alley in local neighborhood
- Fentanyl, guns found during drug bust in Dayton; 1 arrested
“I was like, oh my gosh! I can’t believe this,” she said.
Herres was born with heart problems. When she was 11, she started coughing.
Her family thought it was bronchitis.
“But, I guess it wasn’t bronchitis. It was my heart being so enlarged that it was pushing my trachea, so I couldn’t breathe. And on my parents’ wedding anniversary, March 2 of 2012, he found a blood clot in my right atrium,” Herres said.
Doctors put her on the heart transplant waiting list.
“I was on the highest, top of the list, like critical I guess, and I only waited nine days. I received my heart on March 18, 2012, and then ten days later, I celebrated my twelfth birthday,” she said.
Herres said she got a denial letter from the insurance company this fall.
“They’re saying you don’t have a kidney or liver transplant; you had a heart transplant. This is not medically necessary, and they don’t see it as a treatment for a heart transplant,” Herres said.
But doctors didn’t agree.
While going back and forth with the insurance company, she started getting low on her medication.
At that time, she decided to share her struggles on social media.
“And eventually public pressure did work, but they slapped a price tag on it,” she said. “So, a 30-day supply, just 30 days, I take it twice a day, 350 bucks. 90-day supply is $1000. I can’t afford that.”
Her heart came from a 24-year-old man named Christian.
When Christian’s mom heard about Herres’ struggles, she asked if she could help pay.
“I’m like, you’ve done enough for me. You, you lost your only child, you donated his organs, you gave me life,” she said. “She should not have to worry about me keeping her son’s heart alive.”
A spokesperson with the insurance company told News Center 7 it approved her medication and apologized for the stress this caused her.
The company said it’s reviewing this case to strengthen its own processes and ensure future reviews better consider the individual needs of its members.
[SIGN UP: WHIO-TV Daily Headlines Newsletter]
©2025 Cox Media Group
