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Nampa family faces battle with insurance company in fight for 14-year-old's life

Posted at 5:43 PM, Dec 02, 2016
and last updated 2016-12-02 19:43:40-05

More than 30,000 people in the United States living with Cystic Fibrosis (CF).  Fourteen-year-old Gauge Edwards of Nampa is one of those. 

After a recent stay in the hospital due to a lung infection, doctors told Gauge and his parents, he needs a double lung transplant because his lung capacity has diminished to around 30 percent.

As Gauge and his family battle for his life, they are also facing another uphill battle with their insurance company.

Frank Edwards, Gauge’s father, tells 6 On Your Side, he received a second rejection letter from the insurance company on Thursday.  He says, while the company has approved a team of doctors at Texas Children’s Hospital to perform a double lung transplant, it will not approve medical testing required before the doctors’ can move forward with the live-saving surgery.

Edwards says he has already appealed this second rejection, but if it happens again, he will have to get an attorney to fight to get the insurance company to cover the tests. 

While this is a big setback, Edwards says it won’t stop him. “I’m going to make it happen, whatever I’ve got to do,” Edwards tells 6 On Your Side.

Gauge’s doctors recommended the family see the physicians in Houston, but it will require the family to temporarily re-locate to Houston.  They’ll have to stay near the hospital until Gauge’s transplant and then, remain in the area for three months to ensure Gauge’s body does not reject his new lungs.

Gauge’s mother, Trish Edwards, is ready for the process to get started. “I’m really curious to find out what Gauge’s compatibility is to find out how long we’ll be waiting there,” Trish says.

The costs associated with the relocation, medical procedures and surgery could amount to $200,000.  While the family is overwhelmed with that figure, they’re doing what they can to save and raise money.

There will be a dinner and silent auction to raise money for Gauge’s transplant.   It will be held at the Star Community Barn, 439 N. Star Road, on Sunday, December 11 from 4 p.m. until 8 p.m.  Food will be provided by GoodWood BBQ and there will also be a Cash Bar hosted by PreFunk.  Tickets for the fundraiser are $25.

Anyone who cannot make it to the event, but still wants to help out, can donate to a GoFundMe account set up for Gauge’s medical expenses.