Plagiocephaly - Insurance Coverage

[Guest guest]

We are in the exact situation as you. We thought about having our pediatrician write a letter to UHC also but they seem to be sticklers with not covering the DOC Band unless our son has to have surgery which he doesn't. It's ridiculous that they won't cover this necessary treatment!

I'm going to TRY and get medical assistance through a grant from UHC. Here is the info if you want to take a look.

Children's Medical Care Grants OfferedUnited Healthcare's Children's Foundation is seeking applications fromfamilies needing assistance with medical expenses not covered by theircommercial health insurance for children 16 years of age or younger inland and Virginia. Qualifying families can receive up to $5,000 to pay for medical services such as physical and occupational therapy,prescriptions, wheelchairs, orthotics and eyeglasses.The foundation awarded grants to 450 families last year. To be eligible,families must meet economic guidelines and have a commercial

healthinsurance plan.The application acceptance process is on-going: there is no deadline.Application criteria and additional information are available atwww.uhccf.org.

[Guest guest]

We also have UHC, our policy has the orthotic exclusion. If you have the same

exclusion you can write as many letters as you want but from what I have seen

they wont budge. We applied for the grant that was listed in a previous post.

We are waiting to receive the letter to let us know what the decision was. We

are not overly optimistic, but it would be nice to have some assistance paying

for the band. Did you ask CT if they will give you any kind of a discount? I

go to one of the licensed clinics and they gave us a " discount " because we paid

at the time of casting. She said it was the same as most insurances pay. It

doesn't hurt to ask.

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> My son was diagnosed with severe plagiocephaly by cranial technologies and

when we were about to proceed with treatment (by getting a helmet), our

insurance company (United Health Care) rejected our claim, by saying it will not

be covered (even after we included a letter from our doctor showing its a severe

medical necessicity to have a helmet and its not purely cosmetic). It seems that

craninal technologies helmet costs around 3800$ and is it even possible to

successfully appeal to united health care insurance. Can anyone who has gone

through similar situation, provide me pointers. Appreciate all your help.

>

[Guest guest]

Does United Healthcare have their own band provider? We have MDIPA which is

under United Healthcare and they wouldn't pay for Cranial Technology, but they

would pay for a band from Star and Hanger.

>

> My son was diagnosed with severe plagiocephaly by cranial technologies and

when we were about to proceed with treatment (by getting a helmet), our

insurance company (United Health Care) rejected our claim, by saying it will not

be covered (even after we included a letter from our doctor showing its a severe

medical necessicity to have a helmet and its not purely cosmetic). It seems that

craninal technologies helmet costs around 3800$ and is it even possible to

successfully appeal to united health care insurance. Can anyone who has gone

through similar situation, provide me pointers. Appreciate all your help.

>

[Guest guest]

We received notice today that our daugher was approved for a grant through

United Healthcare Childrens Foundation. I highly recommend you apply. It's

worth a shot, it only costs your time and a postage stamp to save a whole lot of

money. the link is UHCCF.org.

> >

> > My son was diagnosed with severe plagiocephaly by cranial technologies and

when we were about to proceed with treatment (by getting a helmet), our

insurance company (United Health Care) rejected our claim, by saying it will not

be covered (even after we included a letter from our doctor showing its a severe

medical necessicity to have a helmet and its not purely cosmetic). It seems that

craninal technologies helmet costs around 3800$ and is it even possible to

successfully appeal to united health care insurance. Can anyone who has gone

through similar situation, provide me pointers. Appreciate all your help.

> >

>

[Guest guest]

We were in the same position as you 8 weeks ago. My son had severe plagio

(asymmetry index of 18), we have UHC with an orthodic exclusion, received an

initial denial of our claim, paid $3500 of our helmet, and appealed the denial.

I wrote a 63 page appeal that I thought would work (and I'm good at scientific

writing, I'm months away from my PhD). I received a decision letter from our

appeal yesterday - decision upheld, claim denied. They cited the same exclusion

criteria for the denial - which I broke down and tore apart, but they didn't

seem to even consider. I plan on re-appealing to our employer directly, but I'm

not sure it will do much good.

All the best,

Son, August, 7 months, DOC Band Grad 3-19-10

[Guest guest]

Landon, THANK YOU SO MUCH for posting about the grants. I also have UHC with an orthotic exclusion and I'm working on my grant application right now! Who knows if they'll approve us but it's worth a shot!mom to , 7 months, tort & plagiocephalyHanger band since 3/1/10From: Landon <kandl03@...>Plagiocephaly Sent: Tue, March 23, 2010 10:12:17 PMSubject: Re: Plagiocephaly - Insurance Coverage

We received notice today that our daugher was approved for a grant through United Healthcare Childrens Foundation. I highly recommend you apply. It's worth a shot, it only costs your time and a postage stamp to save a whole lot of money. the link is UHCCF.org.

> >

> > My son was diagnosed with severe plagiocephaly by cranial technologies and when we were about to proceed with treatment (by getting a helmet), our insurance company (United Health Care) rejected our claim, by saying it will not be covered (even after we included a letter from our doctor showing its a severe medical necessicity to have a helmet and its not purely cosmetic). It seems that craninal technologies helmet costs around 3800$ and is it even possible to successfully appeal to united health care insurance. Can anyone who has gone through similar situation, provide me pointers. Appreciate all your help.

> >

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