Re: what if Ponseti docs. not covered by my insurance?

[Guest guest]

Tara,

Many parents have had problems with their insurance initially in

trying to go to a Ponseti method doctor who was not on their

insurance system. Some have initially had to pay for the costs

themselves and then request reimbursements. But I beleive that in

the end almost everyone was able to get their insurance company's to

pay. We had that experience ourselves.

Sometimes, parents have had to appeal their insurance companies

decision and point out that the Ponseti method is less expensive,

safer, with great long term outcome studies and not available from

the doctors in their insurance group. After pointing out all of

these details (although it may take awhile), I believe almost all

parents have eventually been able to get their insurance companies

to cover it.

Our appeals for coverage were mostly done by phone with some written

correspondence. Our initial ped ortho would not take our insurance,

but made a special one time agreement with them to cover our son for

90% of all costs and 100% of everything over a 1,000 deductable.

When we switched to Dr. Ponseti at the U of Iowa, our insurance

would only cover 60% of costs for an out of system provider.

I went with some other parents here in Las Vegas to their insurance

companies appeals board. We prepared copies of all of the medical

studies and documentation on the Ponseti method. After asking a few

questions, the appeals board agreed that it should be covered.

It is hard to know exactly what the costs for treatment would be at

NYU. You could call their office and ask if they can give you an

estimate. Five to six years ago at Iowa, my guess is that the full

treatment would cost between $3,000 to $5,000, depending on how many

visits and casts, tenotomy or not, bilateral or not.

and (3-17-99)

>

> Hi there,

>

> First of all, I would like to thank everyone who was so kind in

their

> response to my first

> questions. I don't know what I would do without this group, and my

> baby isn't even born

> yet! You all make this seem manageable.

>

> I have just learnt that the Ponseti docs are not affiliated with my

> insurance plan and I may

> have to pay out of pocket. I live in NYC and have really bad

> insurance! Has anyone paid out

> of pocket for the treatment with a Ponseti Dr. and would you be

able

> to give me an

> estimate of what I might be looking at cost wise. I don't want to

go

> to just any dr. that my

> insurance tells me to, and I need to be prepared financially.

>

> Thank you, again.

>

> Tara

[Guest guest]

I believe I heard an estimate of around $6,000 once. Of course that varies

with different regions of the country.

s.

what if Ponseti docs. not covered by my insurance?

Hi there,

First of all, I would like to thank everyone who was so kind in their

response to my first

questions. I don't know what I would do without this group, and my

baby isn't even born

yet! You all make this seem manageable.

I have just learnt that the Ponseti docs are not affiliated with my

insurance plan and I may

have to pay out of pocket. I live in NYC and have really bad

insurance! Has anyone paid out

of pocket for the treatment with a Ponseti Dr. and would you be able

to give me an

estimate of what I might be looking at cost wise. I don't want to go

to just any dr. that my

insurance tells me to, and I need to be prepared financially.

Thank you, again.

Tara

[Guest guest]

Tara,

Even though the doctors may not be in your provider book, call your

insurance company anyway (if you haven't already) and see what can be done.

Find out if there is any benefit at all that can be applied in this

situation. Also, I am sure that you can call the doctor's office and get an

estimate of the total cost of treatment. I don't think they would give you

a problem with that. I can't imagine the number they give you as an

estimate being astronomical either.

Mommy to (12-17-98) and

Christian (1-30-04) LCF - DBB (nights only)

what if Ponseti docs. not covered by my

insurance?

Hi there,

First of all, I would like to thank everyone who was so kind in their

response to my first

questions. I don't know what I would do without this group, and my

baby isn't even born

yet! You all make this seem manageable.

I have just learnt that the Ponseti docs are not affiliated with my

insurance plan and I may

have to pay out of pocket. I live in NYC and have really bad

insurance! Has anyone paid out

of pocket for the treatment with a Ponseti Dr. and would you be able

to give me an

estimate of what I might be looking at cost wise. I don't want to go

to just any dr. that my

insurance tells me to, and I need to be prepared financially.

Thank you, again.

Tara