A 70-year-old retired San Francisco firefighter battling stage 4 lung cancer is fighting for his life and fighting his insurance company for access to the treatment his doctors say could help him survive.
Ken Jones, who spent 17 years protecting the city as a firefighter, stood at the threshold of potentially life-saving treatment last Wednesday when he received devastating news: Blue Shield of California, the insurer managing his city employee health plan, had denied coverage for the chemotherapy and immunotherapy regimen his UCSF oncologists prescribed. According to NBC Bay Area, the denial came despite an appeal from Jones’s physicians, with the insurer describing the treatment as “outside the standard course of care.”
The rejection forced Jones and his family into an agonizing position: pay roughly $50,000 out of pocket for treatment, or watch his condition deteriorate. “That denial is causing serious harm to Ken’s health and is now threatening his life,” his wife Helen Horvath told the San Francisco Health Service Board at an emotional January 9 hearing, as reported by NBC Bay Area. Horvath, herself a 14-year veteran of the San Francisco Fire Department, described her husband’s painful reality: “He has painful, metastatic tumors in his bones, in his lymph nodes, and soft tissues, as well as tumors in his brain.”
A Pattern of Denials
Jones’s case isn’t isolated—it’s part of a troubling pattern that’s emerged since the city switched from UnitedHealthcare to Blue Shield in January 2025. Fred Sanchez, a former deputy fire chief who now leads Protect Our Benefits, a nonprofit advocating for city retirees, told ABC7 that numerous retired firefighters have reported similar problems with coverage denials. “Most of the people are retired — 60, 80, 90 years old — when they get a denial, they say, ‘Oh, I guess that is, and they give up,” Sanchez said…