ASHEVILLE, N.C. (WLOS) — A Weaverville family is desperate for help as a 35-year-old husband and father is in the hospital, trying to recover from a brain injury.
His doctors believe he could get better if he moves to a specialized rehab facility, but his health insurance won't pay for it.
Ryan Richards has two young daughters and a wife and loved playing music at church.
But on Feb. 17, his whole world changed with an ear ache that turned into an infection and then much worse.
Amber Richards, from Weaverville, NC, says her family's world suddenly changed when her husband, 35-year-old Ryan, got an ear ache on Feb. 17, 2023, which turned into an infection, then developed into a small brain injury. Now, in August 2023, she's fighting to get him moved into a specialized rehab facility, but his health insurance won't pay for it. (Courtesy: Amber Richards)
"He developed a small brain injury, still in the hospital, minimally conscious, part of a brain injury," said his wife Amber Richards. "It's a very slow going recovery."
He's been in the hospital for about six months now.
Amber Richards, from Weaverville, NC, says her family's world suddenly changed when her husband, 35-year-old Ryan, got an ear ache on Feb. 17, 2023, which turned into an infection, then developed into a small brain injury. Now, in August 2023, she's fighting to get him moved into a specialized rehab facility, but his health insurance won't pay for it. (Courtesy: Amber Richards)
During that time Amber has tried over and over again to get him into a rehab facility designed to help patients like Ryan.
One of those facilities even said "he most definitely meets medical necessity criteria."
"Surgeons, hospitalists, doctors at Mission have said that is what he needs, that type of rehab, but insurance has denied, because I guess they don't have enough proof that would be helpful," said Amber.
Documents from his medical team in June show "his labs are improving... He turns his head to voice..."
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Amber Richards, from Weaverville, NC, says her family's world suddenly changed when her husband, 35-year-old Ryan, got an ear ache on Feb. 17, 2023, which turned into an infection, then developed into a small brain injury. Now, in August 2023, she's fighting to get him moved into a specialized rehab facility, but his health insurance won't pay for it. (Courtesy: Amber Richards/photo credit: WLOS Staff)
The same month, a letter from United Healthcare says "your doctor has requested admission to an acute impatient rehabilitation hospital... For strength and activity."
Amber Richards, from Weaverville, NC, says her family's world suddenly changed when her husband, 35-year-old Ryan, got an ear ache on Feb. 17, 2023, which turned into an infection, then developed into a small brain injury. Now, in August 2023, she's fighting to get him moved into a specialized rehab facility, but his health insurance won't pay for it. (Courtesy: Amber Richards/photo credit: WLOS Staff)
It goes on to say "we reviewed the health plan criteria for admission. The admission is not covered... Because you are not able to tolerate the amount of therapy required."
News 13 asked what the hardest part of all this had been for Amber:
Not seeing him get the help he needs," she said.
After appealing the decision, United Healthcare denied the request again, saying "your health plan does not consider your transfer to be medically needed."
Ana Prendergrast is now representing the family, and says she's shocked by the process.
"It's awful, it truly feels impossible," she told News 13.
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The latest healthcare denial on Aug. 3 said, "we cannot approve this because it is not medically needed....the requested hospital rehabilitation is not shown to be helpful for your condition."
"He needs this specific type of care and United Healthcare as an entity is saying, 'nah, we don't think it's worth paying for.' I don't know why they get to decide that," Prendergrast said.
Amber said she doesn't know where else to turn or what else to try as she clings to hope that her husband will someday get better.
"Everyone should be given a chance," she said. "He's 35 years old and needs some help."
News 13 did reach out to United Healthcare.
A representative tells us they are working to get more information on this case.
We will follow up when we get a response from United Healthcare.
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