Let Them Hear
After unsuccessfully trying to get insurance coverage for a much-needed cochlear implant for his hearing-impaired son, former North Platte resident Kevin Fries received some great news last week.
“They obviously went above and beyond the call of duty,” Kevin said.
Kevin grew up in North Platte, and his family lived here for a couple years after finishing college. In 2004, they moved to Grand Island where Kevin works as a recruiter for a collection agency and his wife, Dana, is an attorney.
The Fries family has been working diligently to find a remedy for their son’s hearing loss since 2005. That’s when they first noticed that their son, Grayson, was having some difficulty hearing.
At the age of four, Grayson was fitted with hearing aids to support his hearing loss. A year later, doctors determined that Grayson’s hearing had deteriorated to the point that he needed a cochlear implant.
Rather than amplifying sound like a hearing aid, a cochlear implant is a complex electronic device that converts sound into electrical impulses that can be interpreted by the brain.
The device is implanted behind a person’s ear, and electrodes provide a pathway to the cochlea within the inner ear, sending impulses through the auditory nerve and creating an effect similar to hearing.
The implant does not restore a person’s ability to hear, but it does bring it to a level where the patient is able to function and receive auditory clues that allow them to speak and understand verbal communication.
Grayson received his first cochlear implant in December of 2006 at the age of 5. Afterward, Kevin said his son excelled in school for the remainder of his Kindergarten year, and he had a great start as a first grader.
“He was achieving above normal scores for a child with his hearing disability, and we were confident that he would continue to excel,” Kevin added.
However, Grayson received a contusion on the implant site, resulting in swelling below the skin. Eventually, Grayson developed an antibiotic-resistant staph infection (MRSA) and the implant had to be removed.
The idea was to implant a new device once Grayson had fully recovered. Unfortunately, Kevin’s employer had switched to a different insurance company—one that would not cover a cochlear implant.
With the support of his doctors, Kevin appealed twice to Coventry Health Care of Nebraska without success. In his appeal, Kevin pointed out that 90 percent of health insurance plans cover cochlear implant services.
The appeal also indicated that Coventry Health Care does cover other medically necessary prosthetic devices, yet specifically excludes cochlear implants—the only prosthetic device used for treating hearing loss.
“Something needs to be done about that process and how it all works because this is a disability that is no different than if someone lost an arm or a leg,” Kevin said about his struggles with the insurance company.
Kevin even testified earlier this year before a Nebraska legislative committee that was considering a bill to mandate coverage for cochlear implants. Unfortunately, that bill never made it out of committee this year.
After hearing that their second appeal was denied, the Fries family was preparing to continue the fight with the help of the Let Them Hear Foundation, an organization that provides legal advocacy for patients with hearing loss.
“We were exploring all potential options that we had available to us,” Kevin said.
That’s when they got the call from the manufacturer of the cochlear implant. Kevin said they offered to pay for the surgery, which costs about $28,000, as well as the implant, which is another $85,000.
“They were under no obligation to do something like this, yet they felt with Grayson’s history with their equipment and his need and lack of funding for a new implant that they would do this for him,” Kevin said. “It really was an unexpected miracle.”