Imagine how you would feel if your child needed a device that would greatly improve his life, and your insurance company refused to cover the cost of it. Parents Brian and Shay Rubin are living this experience. Coventry Health Care of Georgia refuses to cover the cochlear implants that their son requires.
Health insurance is expensive. There are families in the United States that are unable to afford it, and who do not currently qualify for public forms of insurance. The result often is that the uninsured end up with a mountain of medical debt – or they go without the treatment that they require.
Families that are able to purchase health insurance should expect their plan to cover at least some of the health care needs of their family. Unfortunately, this is not always how things work out, especially in situations where a child requires treatment, therapy, or a medical device to help with his or her special needs.
Brian and Shay Rubin have two children. Their son, Carson, is five years old. He has a hearing impairment called auditory neuropathy, which can be cured with a cochlear implant. This would requires surgery. He is about to start kindergarten (in the Fall of 2013) and it is obvious why it would be greatly beneficial for him to be able to hear what the teacher, and his peers, are saying.
The problem is that the Rubin’s health insurance company, Coventry Health Care of Georgia, refuses to cover the cost of the surgery that would enable Carson to have cochlear implants put in place. The Rubin’s have started a petition to try and convince Coventry Health Care of Georgia to cover the cost of what Carson needs. Part of the petition says:
However, our insurance provider, Coventry Health Care of Georgia, has a written exclusion for cochlear implants.
The cost of the surgery without insurance is approximately $125,000 per ear – we don’t have that kind of money, and we’re shocked and saddened to learn that Coventry Health Care won’t cover this surgery. We found out that more than 90% of commercial health plans in the country do cover cochlear implant surgery – and Coventry Health Care is one of the largest health care companies in the United States. (emphasis theirs)
The Rubin’s have started a Facebook page called Carson’s Story. You can go there to learn more about the situation. There is also information about how to donate to their fundraiser for the cochlear implants. According to ABC News the family has raised “a few thousand dollars” for the implants so far.
ABC News spoke with Christine Grow, a spokesperson for Coventry Health Care of Georgia. She said that she could not comment about a specific case because of privacy concerns. She also said:
We are not aware of any small group plan in the state that covers this type of surgery.
Image by Steve Johnson on Flickr