Guest guest Posted February 22, 2010 Report Share Posted February 22, 2010 Hi. We have CareFirst in Virginia and had to have 2 bands. Both were denied by CareFirst because they consider it cosmetic. I appealed as far as I could go through the Dept. of Health Care Finance who reccommended that CareFirst cover the treatments fully. CareFirst rejected their recommendation and now my only option is to file a civil suit against CareFirst. Has anyone had a similiar experience or know of anyone who has gone this far? Thanks. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 22, 2010 Report Share Posted February 22, 2010 I haven't, but you can search thru the files for appeals. There may be more info and helpful stuff there. Plagiocephaly/files/Insurance%20Help/ Jen Mom to Luli - 3 yrs old Torticollis, Plagio, Syringomyelia insurance denial Hi. We have CareFirst in Virginia and had to have 2 bands. Both were denied by CareFirst because they consider it cosmetic. I appealed as far as I could go through the Dept. of Health Care Finance who reccommended that CareFirst cover the treatments fully. CareFirst rejected their recommendation and now my only option is to file a civil suit against CareFirst. Has anyone had a similiar experience or know of anyone who has gone this far? Thanks. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2010 Report Share Posted June 27, 2010 Sorry to hear that - how frustrating! You will probably get better help if you can tell us all about your insurance - who the insurer is, the type of plan, and the state where you live. Is it through an employer, etc? There is often someone else on the board who's been in a similar situation. I agree with the last post about finding out exactly what their guidelines are. Ask for a copy of the part of your policy that says you don't qualify. Hopefully, you will find out that you actually DO qualify and they were wrong. Also, find out what laws govern your insurance plan and read them to find out if they are allowed to exclude coverage. If you tell us more about your insurance, we can probably be more specific with our advice. Good luck! > > > > Not sure if anyone can help. My daughter has moderate-severe deformational plagiocephaly. Our insurance company denied our claim because they said they are only covered for adjunctive use for infants from 3-18mts of age whose synostosis has been surgically corrected, but who still have moderate to severe cranial deformities. > > > > Not really sure where to go from here. I'd be grateful for any help. thanks > > > > Lucy's Mom > > > Quote Link to comment Share on other sites More sharing options...
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