Lauren Agoratus: An Advocate Fights Her Own Insurer for Cancer Care

Lauren Agoratus is both an advocate and a mother who has lived the challenges she fights to address. As state coordinator for Family Voices NJ, she supports a network of families of children with special health care needs, and she is raising one of those children herself. Her daughter is medically complex, autistic and a kidney transplant patient.

“I am actually pretty good at advocating for other people, not as good for myself,” Lauren said. That became clear when she faced a diagnosis of her own. “I am a breast cancer survivor, which is not something I normally would share … but this is too important not to.”

Lauren said her journey actually began 15 years before her diagnosis. “I had a weird feeling, and they did find something, but it was nothing, and I knew I was okay, and then when the next time came around, I just knew it was cancer. I don’t know how I knew.”

She kept the news to herself. “I didn’t tell anybody. I didn’t want to go through the whole thing with my mom and dad and say, oh, they found something. Oh, I have to have biopsy. Oh, it’s positive. No, I waited till everything was done, and then I called them and said, I’m okay. I had it removed, and this is the plan.”

Lauren had surgery on July 7, 2022, and learned that radiation is supposed to begin about four weeks after an operation.

Then came “delays, delays, delays.”

Her doctors were calling almost every other day to try to get the insurance company to move. “I kept waiting for four weeks and it was like, July went by and August went by. By September, I was like, okay, we need to do something. This is ridiculous.”

Lauren is part of an immunocompromised collaborative, and one of its members was the Susan G. Komen Foundation. She reached out to her contact there with a question. “Is this a thing? Do they delay cancer care? And she told me it is, and they do, and I could not believe that.”

“I mean, I knew there were prior authorization delays for other things. I did not think it would be for something as serious as cancer,” she said. “Any time there’s something that’s an evidence-based best practice, it shouldn’t need authorization. It’s proven to work. It’s the standard of care. Why the delay?”

Lauren began digging into what delays mean for people facing cancer. Her research turned up a survey in which 96% of oncologists said prior authorization delayed their patients’ treatment and 88% said it drove up patients’ out-of-pocket costs.  36% of oncologists said prior authorization delays resulted in patient death.

With those numbers in hand, she picked up the phone and took her case straight to the insurance company. “I gave them all the statistics from that study about people dying and everything, and then I said, look, every time you delay me every week, you’re decreasing my chances of survival by 3%, and they immediately approved it.”