On Tuesday, the last school bell rang in second-grade teacher Terry Heinecke’s career.

“If people ask me if I’m excited for retirement, it’s difficult to answer that,” Heinecke.

Heinecke’s retirement is bittersweet because of ongoing cancer treatment and a struggle for insurance coverage.

With 35 years of teaching — 32 in Kalispell Public Schools — Heinecke, 57, was planning to work two more years before ending a fairy-tale career and retiring with her husband, Tom.

Heinecke recounted her story sitting next to her husband in the small seats designed for students in Edgerton Elementary School Room 2A, the room where she has taught for the last 25 years.

“I don’t feel like I was ready to go. That was taken from me,” Heinecke said, noting that she cherished teaching second grade. “This is the age level where they are hungry little minds so excited to be at school. They are still learning to read, but are now reading to learn.”

Heinecke has had a packed teaching career that began in 1977 and has taken her around the country speaking on language arts curriculum and training educators for 12 years. She has written and published reading curriculum, chaired literacy committees and earned two master’s degrees and a superintendent’s endorsement.

In 2004, Heinecke was diagnosed with a rare form of carcinoid cancer in her colon and underwent surgery to remove a section of it.

She went into remission until June 2011 when her yearly exam revealed a small cancerous tumor, roughly the size of a peanut, on her collarbone.

Her doctors at Mayo Clinic in Minnesota were optimistic they could kill 90 to 100 percent of the tumor with an aggressive treatment that involved three to five days of intensive radiation.

Heinecke was elated to hear the good news, but the dream soon became a nightmare.

As an employee of Kalispell Public Schools, she was insured under a Montana Unified School Trust health benefit plan. Heinecke said she received verbal approval over the phone from the insurer in July.

“The procedure was set and we started preliminary testing,” she said. “I was coming out of the last MRI and MUST called Mayo Clinic — three to four days before treatment was to begin — saying, ‘We are denying this procedure.’ My husband and I just held each other and cried.”

Her treatment was halted and she became entangled in a court case, fighting for coverage and for her life.

The Heineckes went home to find a letter from the trust stating the aggressive radiation was not medically necessary. Instead, the insurer would cover palliative care. The Heineckes were devastated.

“Palliative care keeps you comfortable until you die,” Heinecke said. “You can imagine why would anybody with a chance of getting a cure accept palliative care?”

The Mayo Clinic filed the first appeal of the insurance trust’s denial. Treatment was denied. Heinecke appealed twice more and twice more was denied.  

Heinecke fanned out the denial letters on the table in front of her. Her husband covered his face with his hands while she read the same reason for denial: “medically unnecessary.”

Over a period of three months, the appeals process was exhausted. She and her husband became frantic — should she cash out her retirement early and take penalties, put their house up for sale in a poor market and take whatever they were offered?

“I contribute and the district contributes every month for insurance. You have insurance for peace of mind,” Heinecke said. “Why have insurance?”

In October, the Heineckes hired an attorney and went to court against MUST. Heinecke said the insurance trust agreed to cover the treatment, but she has refused to sign a waiver releasing MUST from liability.

Heinecke went back to the Mayo Clinic in February to finally receive the radiation treatment.

By then, the tumor had doubled in size and the radiation only could destroy half of it. If more cancer does not die, Heinecke may have her collarbone removed.

“The other half are live cancer cells,” Heinecke said. “I felt deflated.”

She left the hospital asking doctors: “How long can you keep me going? Those words should never have been spoken. Never.”  

Every three months of her retirement now will be spent traveling to Minnesota for exams.

“It’s just a matter of time before it resurfaces to a third place. The odds aren’t great,” Heinecke said.

Heinecke tried to keep tears back because she knows she will never rest from the possibility that the cancer is spreading.

“They’re always looking for it,” Heinecke said. “This truly changed the course of my life.”

Her school sick leave, vacation and personal days wouldn’t cover the amount of time she needs to spend away from work for treatment, so she gave notice in February of her retirement.

“It’s not quite the fairy tale ending,” Heinecke said.

Heinecke is bracing herself to start a “bucket list” and do everything she always has wanted to do.

“It’s hard to figure out what to do first,” Heinecke said

She would like to learn French to visit her sister in France, take watercolor classes, piano classes, volunteer and do her favorite sport, water skiing.

“I’ve got to pack it in and live large. I’m holding onto those things and take the next 20 years and do it in the next five,” Heinecke said.

She returns to the Mayo Clinic on Sunday to see if surgery to remove her collarbone is required.

“It is not OK for people with insurance to be denied necessary treatment,” Heinecke said.

She recalled a Missoulian article in March in which Eric Schindler, MUST chief executive, said two-thirds of costs are caused by 5 percent of the insured.

“Our focus is to keep people out of that 5 percent who are spending 65 percent of the money,” Schindler was quoted in the article. “You have to be able to figure out who it is, and we’ve offered incentives for people to engage in their own health and wellness.”

Heinecke is left wondering if she is part of the 5 percent.

Contacted by the Inter Lake, Schindler declined to comment on Heinecke’s case because “the litigation is ongoing and there are privacy concerns at issue.”

Reporter Hilary Matheson may be reached at 758-4431 or by email at hmatheson@dailyinterlake.com.