Re: Anyone have Tricare Insurance?

[Guest guest]

Kelsi-

We are Navy too. We were denied by Tricare for

banding. Tricare considers this a cosmetic procedure. We have not

appealed the decision. If you are denied you could always try an appeal,

I would get your doctor( primary or ped) to write a letter indicating why

the procedure is medically necessary (check the web-site for info) and not a cosmetic

one. Our ped is not a believer of banding and is under ‘the head

will round on its own’ philosophy, so we received no help

there. My daughter has had many health issues and Tricare has been

great—we have never had to pay a penny for her HUGE, HUGE medical bills—so

I guess we never pressed the issue on the band (her plagio is VERY mild).

Good luck!

Lori

From:

Plagiocephaly [mailto:Plagiocephaly ] On

Behalf Of kelsij

Sent: Thursday, May 28, 2009 1:48 PM

Plagiocephaly

Subject: Anyone have Tricare Insurance?

HI!

My husband in active duty Navy and we have Tricare. We've been married for

almost 2 years but I still get confused about the way everything works. We just

had to submit the claim for my daughter's STARband helmet ourselves and I was

wondering if anyone has gotten Tricare to approve the treatment. We already

paid cash for the helmet because we were told by the doctor and the Tricare Rep

that they probably were not going to cover it and we didn't want to sit around

and wait for it to get approved before we could start treatment. I still want

to see if they will at least pay for part of it it's very expensive.

Thanks!

Riley's mommy,

Kelsi

[Guest guest]

We have Tricare (also Navy). Tricare has an exclusion for cranial orthotics, so our claim was ultimately denied (as we knew it would be). The insurance coordinator for Cranial Tech said that she has had TWO people get coverage in TEN YEARS. And those people ended up appealing multiple times in court. We ended up just paying out of pocket. The reduced (military) rate was $3,000 for a DOC Band.

KimOn Thu, May 28, 2009 at 1:48 PM, kelsij <kelsij1@...> wrote:

HI!

My husband in active duty Navy and we have Tricare. We've been married for almost 2 years but I still get confused about the way everything works. We just had to submit the claim for my daughter's STARband helmet ourselves and I was wondering if anyone has gotten Tricare to approve the treatment. We already paid cash for the helmet because we were told by the doctor and the Tricare Rep that they probably were not going to cover it and we didn't want to sit around and wait for it to get approved before we could start treatment. I still want to see if they will at least pay for part of it it's very expensive.

Thanks!

Riley's mommy,

Kelsi

[Guest guest]

Kim,

yeah, that's what I was afraid of. I don't think it's worth going to court

over since we already got a great discount for paying for it upfront so I guess

that's good. I definitely don't regret going through with the helmet we can

already see such an improvement, it's totally worth the money. I was just

wondering if anyone had gotten it approved.

Thanks so mush for replying!!!

Kelsi

>

> >

> >

> > HI!

> >

> > My husband in active duty Navy and we have Tricare. We've been married for

> > almost 2 years but I still get confused about the way everything works. We

> > just had to submit the claim for my daughter's STARband helmet ourselves and

> > I was wondering if anyone has gotten Tricare to approve the treatment. We

> > already paid cash for the helmet because we were told by the doctor and the

> > Tricare Rep that they probably were not going to cover it and we didn't want

> > to sit around and wait for it to get approved before we could start

> > treatment. I still want to see if they will at least pay for part of it it's

> > very expensive.

> >

> > Thanks!

> > Riley's mommy,

> > Kelsi

> >

> >

> >

>

[Guest guest]

Lori,

That's what I was afraid of. It's definitely not worth all the hassle of

appeals and going to court since we already got a pretty good discount for

paying upfront. I was just wondering if anyone had gotten it approved so I have

a better idea of what to expect. And as far as Insurance goes Tricare is pretty

much the best one out there so I guess I can't complain too much.

Thank you so much for replying!

Kelsi

>

> Kelsi-

>

>

>

> We are Navy too. We were denied by Tricare for banding. Tricare considers

> this a cosmetic procedure. We have not appealed the decision. If you are

> denied you could always try an appeal, I would get your doctor( primary or

> ped) to write a letter indicating why the procedure is medically necessary

> (check the web-site for info) and not a cosmetic one. Our ped is not a

> believer of banding and is under 'the head will round on its own'

> philosophy, so we received no help there. My daughter has had many health

> issues and Tricare has been great-we have never had to pay a penny for her

> HUGE, HUGE medical bills-so I guess we never pressed the issue on the band

> (her plagio is VERY mild).

>

>

>

> Good luck!

>

> Lori

>

>

>

>

>

> From: Plagiocephaly [mailto:Plagiocephaly ]

> On Behalf Of kelsij

> Sent: Thursday, May 28, 2009 1:48 PM

> Plagiocephaly

> Subject: Anyone have Tricare Insurance?

>

>

>

>

>

>

>

>

> HI!

>

> My husband in active duty Navy and we have Tricare. We've been married for

> almost 2 years but I still get confused about the way everything works. We

> just had to submit the claim for my daughter's STARband helmet ourselves and

> I was wondering if anyone has gotten Tricare to approve the treatment. We

> already paid cash for the helmet because we were told by the doctor and the

> Tricare Rep that they probably were not going to cover it and we didn't want

> to sit around and wait for it to get approved before we could start

> treatment. I still want to see if they will at least pay for part of it it's

> very expensive.

>

> Thanks!

> Riley's mommy,

> Kelsi

>