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Paralyzed former wrestler fights Blue Cross for nursing care

Posted December 22, 2016

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— Luke Hampton is paralyzed from the neck down and requires 24-hour care to eat, bathe and even breathe.

"I can't do anything for myself," the 23-year-old said from his home in northwest North Carolina.

Hampton was a star high school athlete in Alleghany County and one of the top wrestlers in the state until he slammed his head into a gymnasium wall while driving his opponent off the mat in a 2011 match.

"I knew that there was something bad, wrong," he said of the accident.

For years, the State Health Plan paid for 18 hours of home nursing care per day for Hampton.

"That's what they're there for, to support your needs to be able to live," he said of his nurses.

But Blue Cross Blue Shield of North Carolina, which handles claims for the State Health Plan, recently notified Hampton's family that the nursing care would stop within 45 days.

"Until my dying days, I'll take care of him, but I just don't know what we're going to do. I need to work and provide insurance," said his mother, Benita Hampton.

Blue Cross officials declined to comment on Luke Hampton's case, but the company's policy on private duty nursing says that, if Blue Cross determines a patient is stable and not in need of constantly changing medical care, nursing services are no longer necessary.

"Private duty nursing is ... temporary in nature and is not intended to be provided on a permanent basis," the policy states.

Benita Hampton said she has been lobbying for more nursing care for her son, calling doctors and lawyers for assistance, and family friends set up a Facebook page for support.

After the family appealed, Blue Cross gave Luke Hampton a temporary reprieve to keep 12 hours of daily nursing care into the new year, but that will gradually be reduced, and he, his girlfriend and his family worry about what comes next.

"Look at him as a person and not just a file, not just a number, not just a dollar that they're going to save," Benita Hampton said.

Adding to the family's frustration, Blue Cross forced them to sue Alleghany High School over the wrestling accident, and the insurer recouped nearly $2 million as a result.

Because of Luke Hampton's injury, North Carolina high schools are now required to place wrestling mats at least 10 feet from walls.

4 Comments

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  • John Archer Dec 23, 11:14 a.m.
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    ACA has nothing to do with this. This is a classic case of two things 1. the insurance companies actually control everything about health care in the USA, and 2. doesn't the GOP expect families and churches to take care of people like this? With the gut to SS and medicare coming next year, the number of people in this situation will rise exponentially. Don't know why people are shocked at this.

  • Bryan Jeffries Dec 23, 7:44 a.m.
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    I'm waiting for people to chime in with how our current healthcare system is just aces...

  • Janet Ghumri Dec 22, 8:59 p.m.
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    So, winning a 2million settlement, and it goes straight to BC/BS?? While the family struggles to pay premiums, and find round the clock care for the patient?? Does this seems bass-akward to anyone else?? Smh

  • Ron Coleman Dec 22, 8:05 p.m.
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    I had basically the same problem with BC/BS regarding my son. I went to my human resources manager told her what BC/BS said and she got on the phone right then and spoke with the same woman that told me no and proceeded to ask her who she thought she was and informed her that our company was self insured and paid them to only administer the policy and that she did not have the authority to tell me no and she better take care of this or they would no longer have the account. My son had a nurse and a full time aid that afternoon.