Family desperate after insurance reduced for son with birth defect

YUKON, Okla. - One Yukon family said their Oklahoma Medicaid coverage has severely dropped and are now speaking out trying to find care for their child.

The Ammons family travel every six weeks to Boston.

It’s an agreement SoonerCare agreed to cover.

After years of heartache, the worried mother said the clock is ticking.

“Everything is a fight,” Shawna Ammons said. “Everything that goes into having a medically complicated child is a fight.”

This fight is not slowing the Ammons family down.

Ryker was born with a rare birth defect, gastroschisis.

That means his intestines were outside his body.

“He went straight into surgery and they removed a pound of intestines, which is 85 percent of his intestines,” Ammons said.

The Centers for Disease Control and Prevention estimates that about 1,871 babies are born each year in the United States with gastroschisis.

After months of no answers, the family traveled to Boston Children’s Hospital where some of the top gastroenterologists practice.

Shawna Ammons said it was a decision Oklahoma Medicaid agreed to cover.

“They said that if we would've waited any longer, he wouldn't of made it,” Ammons said.

Ammons said over the last two and a half years, SoonerCare has covered more than half the medical costs.

That is until a call came Thursday morning with shocking news.

“Now they decide they only want to pay 10 percent,” Ammons said.

47 percent of her son’s medical coverage is now being cut.

“If seeing your child suffering isn't hard enough, they drag you through the loops and stuff just to keep them alive,” Ammons said.

Ammons says little information has been given to her about why.

News 4 reached out to SoonerCare.

A representative said she couldn’t comment on this specific case but pointed us to their policy stating these agreements can be renewed.

A decision that now threatens to tear this family apart.

Ammons said she and her husband now are considering a divorce in order to get the money they need to keep their son alive.

“I’m supposed to be his mother and advocate for him and if that means going against my own state that I live in then I guess that is what I am going to do,” Ammons said. “And if they don’t I guess I will pack my bags and find a state that will.”

If Ryker is no longer able to see his doctor in Boston, Ammons said she will have just three months to find him a new doctor.

SoonerCare has provided Ammons with closer options, but the mother said they don’t specialize in the care her son needs.

The Ammons family has set up a GoFundMe page to help with medical costs. If you would like to donate, click here.

News 4 will continue to update this story.

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