RSV Shots / problems with insurance

[Guest guest]

Hi all. I'm sorry this is going to be a bit long, but I have to get

this off my chest. I feel so powerless in the decision of how my

child is to be treated, and it all based on $$$$$!

The day before xmas we received a call from a company that our

insurance had contacted with regarding the RSV shots. (Previously our

doctor had written a letter and filled out a bunch of paperwork so

that the insurance would cover Adam's RSV injections, since he was a

month premature and has cf he doubly qualifies for this preventative

medicine.)

The company said they are in charge of shipping each injection to the

doctor's office each month and needed us to send our copay before

they'd ship this first dose. (I'm not sure where it came from but

Adam already had one shot in November...)

She listed off the price of the shot -- over $1000. And then

explained to me that it is subject to our deductible being met and

then the 20% copay after that until me meet the out-of-pocket max. I

explained that we met the deductible in October with a minor surgery.

So then she informed me that our 20% is $350!!!! They needed it

before they'd ship the dosage. I told her there was no way I could

lay my hands on $350 now. She put me on hold and came back, her

supervisor said they could ship it for $200. A light breeze could

have blown me over at that time. This is preventative medicine?

I told her to just forget it, we are still trying to pay our

out-of-pocket portion of Adam $123,000 hospital stay last spring. I

guess he won't get the shots. And then I just hung up on her.

I guess the insurance would rather take the chance of my child ending

up in the hospital due to RSV than just cover the blasted shots! What

is wrong with this picture!?!?

I'm so frustrated, right now. I had to share. I know many of you

reading this have had this and much more, but this is my first real

experience with this. How dare the insurance company and their

affliates tell use we have to pay $350 a shot per month through March

just to avoid potential long-term problems for ANY child, let alone a

cf child.

I'm disgusted....

On another note, anyone know anything about the military system? Have

any pointers for me? How about the National Naval Medical Center's CF

Clinic. We are moving to Virginia, outside DC this June. My husband

has received title-10 orders to the National Guard Bureau, across the

street from the Pentagon. So in June we go onto TRICARE. (On an even

more personal note, starting in June I get to stay home with my

darlings full-time!!! I'm excited. I get to be home for the most

formative years of my children. Words can't express the nervousness

and elation that I'm feeling.)

Thanks for listen and any advice you have to share,

Crystal and Steve

parents to Adam 10mo wcf, le 3yr nocf.