Thirty-six hours before his wife was scheduled for a major surgery, New York Times personal finance columnist Ron Lieber got a letter in the mail that sent him reeling. 

Insurance was denying prior authorization for the surgery. The only way forward would be to appeal the decision. But it was Saturday night, and the surgery was Monday morning. There wouldn’t be any time. Should they even go to the hospital?

They decided to bet on being able to reverse the denial later on, but the last minute coverage  questions left Ron’s wife, New York Times reporter Jodi Kantor, going into surgery that Monday with a brand new sense of stress and anxiety. 

And along with worrying how his wife's surgery would go (spoiler: it was successful), and whether they’d end up on the hook for a bajillion dollars, it left Ron to wonder why no one had given them a heads-up earlier.

He set out to find answers — and whether there might be a way to prevent these last-minute denials from sneaking up on other people. 

Ron turned to his "Your Money" newsletter subscribers for ideas, and eventually published a draft letter in his New York Times column that doctors and other health care providers could give their patients to better prepare them for insurance curveballs. 

Check out the column here – and consider passing it along to any health care workers whose patients you think might benefit. 

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show. 

Thirty-six hours before his wife was scheduled for a major surgery, New York Times personal finance columnist <a href="https://www.nytimes.com/by/ron-lieber">Ron Lieber</a> got a letter in the mail that sent him reeling.&nbsp;
Insurance was denying prior authorization for the surgery. The only way forward would be to appeal the decision. But it was Saturday night, and the surgery was Monday morning. There wouldn&rsquo;t be any time. Should they even go to the hospital?
They decided to bet on being able to reverse the denial later on, but the last minute coverage&nbsp; questions left Ron&rsquo;s wife, New York Times reporter Jodi Kantor, going into surgery that Monday with a brand new sense of stress and anxiety.&nbsp;
And along with worrying how his wife's surgery would go (spoiler: it was successful), and whether they&rsquo;d end up on the hook for a bajillion dollars, it left Ron to wonder why no one had given them a heads-up earlier.
He set out to find answers &mdash; and whether there might be a way to prevent these last-minute denials from sneaking up on other people.&nbsp;
Ron turned to his <a href="https://static.nytimes.com/email-content/MY_sample.html">"Your Money" newsletter</a> subscribers for ideas, and eventually published a draft letter in his New York Times column that doctors and other health care providers could give their patients to better prepare them for insurance curveballs.&nbsp;
<a href="https://www.nytimes.com/2025/10/22/your-money/prior-authorization-health-insurance.html?unlocked_article_code=1.JlA.MrrJ.zCdji0rCJedL&amp;smid=url-share">Check out the column here</a> &ndash; and consider passing it along to any health care workers whose patients you think might benefit.&nbsp;
<a href="https://armandalegshow.com/episode/ron-lieber/#transcript">Here&rsquo;s a transcript of this episode</a>.&nbsp;
<a href="https://armandalegshow.com/contact/">Send your stories and questions.</a> Or call 724 ARM-N-LEG.
Of course we&rsquo;d love for you to<a href="https://armandalegshow.com/support/"> support this show</a>.&nbsp;

An Arm and a Leg is a podcast about why health care costs so freaking much and what we can (maybe) do about it.

If you’ve ever been surprised by a medical bill, you’re in good company. But as our team of seasoned journalists has learned from years of reporting — you’re not always helpless. We don’t have all the answers, but we’ll offer you tools and big picture insights with plenty of humor and heart. 

An Arm and a Leg is co-produced with KFF Health News and distributed in partnership with KUOW.

You can support An Arm and a Leg by donating at armandalegshow.com/support/

Show Credits: Created, hosted, and produced by Dan Weissmann with senior producer Emily Pisacreta and engagement producer Claire Davenport, edited by Ellen Weiss. Audio wizard: Adam Raymonda. Music is by Dave Weiner and Blue Dot Sessions. Bea Bosco is our consulting director of operations. Lynne Johnson is our operations manager.

An Arm and a Leg&nbsp;is a podcast about why health care costs so freaking much and what we can (maybe) do about it.
If you&rsquo;ve ever been surprised by a medical bill, you&rsquo;re in good company. But as our team of seasoned journalists has learned from years of reporting &mdash; you&rsquo;re not always helpless. We don&rsquo;t have all the answers, but we&rsquo;ll offer you tools and big picture insights with plenty of humor and heart.&nbsp;
An Arm and a Leg is co-produced with <a href="https://kffhealthnews.org/">KFF Health News</a> and distributed in partnership with <a href="https://www.kuow.org/">KUOW</a>.
You can support An Arm and a Leg&nbsp;by donating at <a href="https://armandalegshow.com/support/">armandalegshow.com/support/</a>
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Show Credits:&nbsp;Created, hosted, and produced by Dan Weissmann with senior producer Emily Pisacreta and engagement producer Claire Davenport, edited by Ellen Weiss. Audio wizard: Adam Raymonda. Music is by Dave Weiner and Blue Dot Sessions. Bea Bosco is our consulting director of operations. Lynne Johnson is our operations manager.