by: Rachel Stockman Updated:
MONROE, Ga. - Life-changing surgery to help a Walton County boy who is considered legally deaf is in limbo.
The family’s insurance company denied coverage for cochlear implants, leaving the family few options.
“If he wants to be able to read, write and learn, and have friends; be a kid, he needs to have the surgery,” Brian Rubin told Channel 2’s Rachel Stockman.
Carson Rubin, 5, suffers from auditory neuropathy. He has tried several hearing aids, but so far, nothing has worked. Doctors say the best opportunity for him to live a “hearing” life, would be if he got the implants.
“We pay for insurance. We have coverage and you expect the thing you need will be covered,” Shay Rubin said.
The Rubin’s insurance, Coventry Health Insurance of Georgia, said that the surgery was excluded under their small group plan. The surgery costs about $250,000 for both ears.
“We’ve done hundreds and hundreds of implants and never had a surgery denied,” said pediatric audiologist Jolie Fainberg, with the Atlanta Speech School.
Fainberg said she was shocked to learn about the Rubin’s situation. She added that most insurance plans cover the procedure including Georgia’s Medicaid program.
Christine Grow, a spokesperson with Conventry Health Insurance of Georgia, said she could not comment about Rubin’s specific case because of privacy concerns.
“But we are not aware of any small group plan in the State of Georgia that covers this type of surgery,” Grow added.
“We’ve tried to jump through lots and lots of different hoops,” said Shay Rubin. Rubin said they can not afford the $250,000 surgery, and are now turning to the community for help.
“I want it more than anything in the world,” Carson’s mother added.