He needs $25K for service dog, but insurers won't pay. So NJ man is appealing for help

Service dogs — specially trained to provide physical assistance and emotional support — can help to foster independence and improve quality of life. But they also cost tens of thousands of dollars.

That's the challenge facing Belleville’s Albie Nieves, a 23-year-old man with multiple medical challenges, who says his life could be dramatically transformed by the addition of one.

Although the benefits of service dogs are widely acknowledged, access can be challenging for the estimated 500,000 Americans who rely on them. Public programs and insurance coverage often don’t cover the expense, leaving many who are already facing hardship to seek community support and raise money independently.

Nieves was quoted a price of $25,000 for a dog to help him navigate his mobility, visual and emotional impairments. When he and his parents found out their Medicare insurance wouldn't pay for the animal, Nieves started a GoFundMe campaign. As of Wednesday, $4,100 had been collected.

"I worry that it's not gonna happen every day," Nieves said. "It's in the back of my mind constantly."

The cost of a service dog can vary depending on breed and the type of training required. The animals generally run between $15,000 and $30,000, and some can cost as much as $50,000, according to the National Service Animal Registry, a Colorado company that says it sells products and services to an estimated 50,000 people with disabilities each year.

Nieves’ medical hurdles include McCune-Albright syndrome, a rare disease that stunted his bone growth, as well as cerebral palsy, a group of disorders that affect the ability to move and maintain balance and posture. He also has a cortical visual impairment. All significantly affect his well-being, said Albie and his mother, Patricia Nieves.

"He was a preemie," said Patricia, who also has 16-year-old daughter. "He had a stroke inside me, and we faced numerous complications.”

Patricia, who has the autoimmune disease lupus, said she had a life-threatening complication during pregnancy and delivered Albie during an emergency C-section. He was born 2 pounds and 1 ounce at 28 weeks old. Both he and his mother almost died that day, she said.

“There was a stroke in the placenta. He went without oxygen in utero. It was a miracle that both of us survived. After birth, he had to stay in the hospital for four months due to numerous complications,” Patricia said.

How service dogs can help

A trained service dog could help with many of the emotional and sensory problems her son has since faced, she said.

Everyday tasks and social interactions are difficult for Albie, but he’s a determined person, his mom said. It’s his nature to tackle problems head-on. She used a movie theater as an example: They scare Albie. He hates being in the dark, where his vision problems put him at a disadvantage.

“If there's a crowd of people, he can't distinguish faces. If there's a flat floor and there's a black piece of tape across the floor, he can't tell if it's flat or a hole, so he steps over it because he's afraid he's going to fall. It’s the same thing with a curb. He can't tell if the curb is 3 inches [high] or a foot,” Patricia said. Things in her son’s peripheral vision look like they are swimming in “a kaleidoscope.”

Albie also feels isolated in movie theaters. A fear comes over him that he will be left alone.

Yet the cinema is the first place he intends to go if he gets a service dog.

The animal was Albie’s idea. When he saw on the web what service dogs could do, he decided he needs one.

Emotional support

"We realized that a service dog could be life-changing," Patricia said. "The dog could provide physical assistance during walking and help him navigate stairs, as well as offer emotional support during anxiety-inducing situations, such as movie theaters."

Albie took the initiative and set up the GoFundMe campaign, which he hopes will pay for the animal.

"We wanted to give him the independence and freedom he deserves," Patricia said. "The support we've received has been heartwarming, but there is still a long way to go."

Patricia said her son is covered by Medicare, the government insurance program, through a plan administered by Florida-based WellCare Health Plans Inc. She said she was told in a telephone call that a service dog for Albie would not be covered.

WellCare did not respond to requests from NorthJersey.com seeking comment.

Patricia's husband manages a formal wear store in Bloomfield, while her health keeps her from working, the mother said. She said virtually all of their earnings have gone toward paying insurance and doctor copays throughout her son's childhood.

“Eleven years ago, I actually got very, very sick myself. My lupus got very bad and I had to leave work and we had to pay for COBRA, and then we had to pay out of pocket for insurance,” said Patricia. “It was tough.” Most recently, Patricia's bout with COVID that turned into long COVID has added to the family's expenses.

A lot goes into training these canines to understand their owner's needs. The one Albie hopes to get would be able to detect changes in his cortisol levels that would indicate rising anxiety, and then provide comfort. It would be able to assist with tasks such as walking down the street, stepping on and off curbs and even going to a movie.

"I think it will help me with my anxiety and depression," Albie said. "I want to be more independent, go out into this world, explore, and go to the movies, especially to watch sports films."

Gene Myers covers disability and mental health for NorthJersey.com and the USA TODAY Network. For unlimited access to the most important news from your local community, please subscribe or activate your digital account today.

Email: myers@northjersey.com

Twitter: @myersgene

This article originally appeared on NorthJersey.com: Insurance won't cover service dogs, Belleville NJ man raising money