When her insurance company denied her coverage to treat a stomach condition that causes frequent vomiting, Sandy Honig decided to appeal the decision in a more unconventional way.
The comedian — who is known for co-creating the show “Three Busy Debras” on HBO Max — uploaded a video, which has since gone viral, that shows her vomiting outside the insurance company’s building. Multiple times.
“Well, no one will take my letter, but they said I could mail it and leave it with any relevant documentation,” Honig says in the video, before opening the envelope and throwing up into it.
Her “appeal” may not have worked, but the viral stunt has sparked a discussion online over the lengths that many Americans have to go through to receive affordable medical care.
Honig, 30, has been vocal about her condition, gastroparesis, which affects her stomach muscles and prevents her stomach from emptying properly.
It causes her to vomit up almost everything she eats, she said in a tweet, and she currently manages it by snacking “slowly on small amounts of simple foods throughout the day.”
"It was getting to the point where I didn't want to get out of bed in the morning, because getting out of bed would mean I would have to drink water and eat food and that makes me feel sick," Honig told NBC News. "You need food to survive and you need water to survive, but those things make me sick ... You have to make a choice to make yourself sick in order to live."
Honig had tried multiple treatments, going as far as getting one medication in Canada because it wasn’t FDA-approved yet.
One treatment that has worked for her, she said in her YouTube video, is receiving Botox injections to her pyloric sphincter, the muscles that controls the movement of partially digested food from the stomach to the small intestine. Before she received the treatment, which is delivered endoscopically, she said she was vomiting more than three times a day. After the treatment, she said she only vomited "once or twice a week."
She said her insurance provider, Anthem Blue Cross Blue Shield, deemed the procedure medically unnecessary. Since the relief from Botox only lasts for a few months, Honig said she would be billed $3,000 multiple times a year.
Desperate for relief, Honig said she received her first Botox treatment without Anthem's approval. She has spent the better part of this year fighting for coverage with the support of her doctor.
She was pushed to her "breaking point" when, after celebrating a "wonderful" New Year's Eve at a friend's home, she returned home to Anthem's denial letter in her mailbox.
Her video, which she filmed in January and posted on Instagram, Twitter and YouTube on Monday, opens with her writing a letter appealing a decision from Anthem. She then attempts to hand-deliver it to the company’s office building in in Woodland Hills, California. After she is denied entry because she didn’t have an employee badge, Honig spins on her heels, exits the building and promptly vomits outside its doors.
She continues to vomit in the parking lot multiple times in the video, horrifying passersby.
Honig alleges that Anthem sent police officers to her home after she filmed the video in front of the company’s building.
She also showed a snippet of the Jan. 19 police report, which said the Los Angeles Police Department “conducted a wellness check.” The report also included the phrase “poss 5150,” the California law code for an involuntarily psychiatric hold. She also tweeted a selfie with an officer in the background.
A representative for Anthem did not comment on Honig's claim that the company sent cops to her home after the incident was filmed.
However, the representative said, the company’s coverage polices are “based on evidence-based medicine utilizing medical society position statements, leading peer-reviewed medical journals and input from physician specialists across the country."
“We want to ensure Ms. Honig gets the right treatment for her particular condition," the representative said in an email. "Our clinical team has carefully reviewed her case and our medical policies, and the existing medical evidence does not support the treatment she is requesting for her condition. Therefore, it is not a covered benefit under the family’s health plan."
The representative added that Anthem’s appeal process affords “additional review” that provides “further opportunities for new or additional facts and circumstances to be considered under the family’s health plan.”
Hours after posting the video, Honig tweeted that someone from Anthem called her and said "they feel awful" and that the company is “looking into it.” In another tweet, she said that the representative called back and explained why Anthem doesn’t consider Botox medically necessary.
“i guess now is the time to admit it IS cosmetic, I just turned 30 and want the inside of my stomach to look younger,” she joked.
Honig described the Anthem representative's second call as a "slap in the face." The procedure had worked so well for her, she said, that she recently received a second Botox injection last week. While her doctor was finally able to convince Anthem to cover part of the cost, Honig expects to face "more bills and denials."
Following the video's release, many online rallied by Honig, sharing their own experiences attempting to appeal to their health care providers.
"My brother had a similar rare stomach disease called SMAS where he couldn't keep food down," one Twitter user replied. "He was 19 when the only thing our insurance would cover was a surgery for a feeding tube even though there's a bypass surgery that would allow him to live a normal life."
In the next tweet, the user said that their brother received the surgery in an "emergency capacity," but his insurance still hasn't paid for it.
"So sorry you're going through something similar. It was a really hard and scary time for my family but this was three years ago and now my brother is totally fine and living a normal life thanks to that surgery," the user wrote. "The American healthcare system is beyond a nightmare."
Actor and writer Jesse Nowack quote tweeted Honig's video, and said that Anthem denied coverage for a medical procedure when he was urinating blood.
Another Twitter user said that their sister had to get a pacemaker in her abdomen to treat her gastroparesis, and it was "a long struggle" to receive that treatment.
Oklahoma Progress Now, a progressive advocacy group that builds coalitions and creates progressive content, also tweeted a response.
"The real tough thing to swallow here is that so many people still assume folks are over-utilizing the healthcare system (for very real disorders and illnesses) vs greedy insurance companies, drug companies and private medical institutions simply rationing care for more profits," the nonprofit wrote.
Some commenters found the video entertaining, even if demoralizing.
"I also have gastroparesis and my old insurance company refused to cover any motility meds," another user wrote. "I’ll keep this strategy in mind."
Honig said she feels "lucky" that she could afford the steep bill to cover the Botox if she "really needed to," but added that her show, "Three Busy Debras" was just canceled. Although she'll have healthcare coverage for another year through the Screen Actor's Guild, Honig said she's angry that "health care is so tied to employment."
Honig said that it's "nice to know" that other people share her frustrations with the American health care system, and hopes that although absurd, her video "opens their minds" to the flaws in private health insurance.
She remembered a poignant comparison that her friend brought up at a recent lunch.
"If there's a fire in your house, you call the fire department, and they show up and they put out the fire," she recalled her friend saying. "You don't call the fire department, and they go, 'Well we're going to talk to your insurance and see if they are going to determine whether or not this fire actually requires putting out.'"