Mick's neurology appt
At Mick and Mack's 4 month appt, their pedi referred Mick to a neurologist because of Plagiocephaly. Plagiocephaly is a flattening of the head/skull that often occurs in multipes and preemies, both of which apply here.
Today was his appointment.
We waited 3 hours until we were seen. Good thing I had a bottle and juice on hand!
We finally got in and the doctor questioned me on what we had done so far to get him off his left side. Then he gave me a rundown of their last conference on plagiocephaly and the three different opinions that were given by the top neuro's in the country. Then he said that Mick's isn't the mildest he has seen this week but he's also not the worse. He then said that MOST children round out by age 2 but there's always that 1 or 2 that don't and further measures (corrective surgery) have to be taken. He gave me a prescription for the helmet and scheduled an appt to come back in two months. He said if we were going to do the helmet, now was the best time rather than waiting. I would rather Mick be in a helmet now when he won't remember it than possibly be that 1 or 2 that doesn't round out naturally and then face surgery.
Not my baby!
Then he told me that Tricare won't pay for the helmet and that it's $2500.00
That is unacceptable.
Tomorrow I'm going to take the prescription to the company that makes the helmet. Then I'm going to wait to see if Tricare refuses. Then I'm going to raise total and pure hell. I haven't served 19 years in the Air Force and been promised medical care for me and my dependants for Tricare to refuse care.
Nope, nope, nope. My red's gonna come out.
posted by Twin Mommie @ 7:52 PM
8 comments
8 Comments:
Good Lord! You go girl! I know you'll win that one!
Oh yeah, on any pediatric doctor visit, always be prepared to wait at least 2 hours. I can't tell you how many hours I spent in waiting rooms with my kids. ARG!!! But we all know - mom's time is not important, only the doctor's time is important.
They probably have some cutesy way to deny it because "it's cosmetic." GRRR! I think I'd put then on my "must bite" list. KathyK
One way I can think of is to have the neuro write a letter to the insurance company stating Mick's medical condition, what it is completely, what the helmet will be used for and how and why it would be used for preventative measures not cosmetic purposes and what it would be preventing should it not be used. Then have the neuro fax this to the insurance company along with a prescription for it.
They're more apt to cover it then if they know it's preventative and not cosmetic.
Good luck and best wishes to you and your babies.
You and your boys are in my prayers. (And should I say some for the Tricare people for when you're done with them...sounds like they'll need it.)
Good luck with the helmut, I know you've gotten some great advice and you and the doctor will tag team the idiots so I'll just say Go Get "Em and send hugs. There's nothing like a determined mother to shake up any system. Sue
Hi,
I came across your blog after a google search. I'm not sure if this is old or not but will check back.
My son will be 8 months old next week and had his DOC band fitted on Wednesday. Tricare refused to pay so we ended up paying the $3000 out of our own pocket. I fully intend on making an appeal and I was wondering if you had any luck ? I am so angry they're refusing.
I would really appreciate it if you could let me know how you got on.
Thanks,
Tammy
Hi Tammy,
I went through Air Force Aid Society and they gave me a grant for $2100 to pay for his helmet and care. I had no luck with Tricare although technically (and this is straight from the Air Force Aid Society person) there was an amendment made in 2004 (I think) and Tricare is supposed to pay for the helmets, unfortunately it's never been added or enforced.
Check with your local Air Force Aid Society office at Family Support and see if they can help you. I wish you tons of luck.
The worst thing the military ever did was go to a HMO for our care.
Hey, i'm going thru the same thing. i shelled out $1400 for a helmet, and tricare is saying they won't pay for it. we'll see about that. Please let me know at fasto4720@gmail.com if you have any luck.
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