Oldham County family fighting health insurance company for continued rehab coverage for son with brain injury
A father from Oldham County is fighting with his health insurance company to keep his son at Frazier Rehab after a he sustained brain injuries from a "freak accident."
LOUISVILLE, Ky. (WDRB) – A father from Oldham County is fighting with his health insurance company to keep his son at Frazier Rehab after he sustained a brain injuries from a "freak accident."
After piece of metal was lodged in 16-year-old Tristan Ballinger’s head in an accident on Dec. 7, 2016, he was brought to Frazier Rehab in a coma. He came out of the coma after Christmas.
Mike Ballinger, Tristan’s dad, said he has made great progress since then. Tristan is now able to move his head, arms and legs. Ballinger said his son can also hold a conversation and is eating solid foods. He said he’s so proud of his son because many people believed he would never be able to talk or move again.
But Ballinger said the family’s health insurance company notified them last week that United Healthcare would no longer cover his stay at Frazier. Ballinger said the company told him its doctors did not believe Tristan was making enough progress to keep him at Frazier Rehab.
Ballinger said Tristan’s doctors and the family disagree with the company.
"The contention is United Healthcare is saying he needs to be put in an acute care facility,” Ballinger said. “That was the recommendation by their medical doctor, which is basically a nursing home. And in the state of Kentucky, we don’t have a pediatric nursing home that provides the type of therapy that Tristan is getting today."
The family made an appeal to the insurance company, because the original coverage was only approved through Tuesday. Late Tuesday, the company responded to allow Tristan one more week at Frazier. The coverage must be approved by the company on a week-to-week basis.
"I'm not fighting for myself,” Ballinger said. “I'm fighting for my son's future. These are the times when he needs me to go to bat for him. So we'll do whatever it takes to make sure he gets the care that he needs to get."
In the meantime, the family is rushing to prepare their home with a ramp and other equipment in case Tristan needs to come home earlier than expected. And Ballinger said if the insurance company doesn’t accept the appeal, they would have to pay out of pocket each day.
Gov. Matt Bevin, Sen. Mitch McConnell, and Congressman Thomas Massie’s offices have also been made aware of the family’s situation.
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