Guest guest Posted October 3, 2010 Report Share Posted October 3, 2010 Our insurance has requested that we do another request for medical necessity. I called because the Cranio-facial specialist we saw last week said it was likely we would outgrow this helmet before the end of treatment. Treatment expected to be 10-11 weeks and we are only coming up to the end of week 6 and she is growing very fast). Our helmet has always been loose and usually lands on her eyebrows but they have always told us it fits correctly so I don't know. Easiest way to find out about the coverage would be to just call the insurance company directly about it. I'm going to request that Cranial Tech send in another medical necessity letter before we outgrow this helmet so there will not be a lapse in treatment. Good Luck. Keep nagging them about the fit until you get answers. Mommy instinct is best and my nagging finally got us to a cranio-facial specialist who answered my questions. > > My daughter is 11 months and has been in her band for 3 1/2 months. It seems like we have made adjustments almost everytime due to ridges or dents forming, and it has always fit pretty loose. She has made some progress but is still pretty flat at the top left side back of her head. Now I am told that there is some concern that this area has not filled out much and I probably need a second band. I questioned whether it ever fit properly to begin with, but of course the answer was yes. It is not like she outgrew it, there is still plenty of room. My insurance covered 80 % of the first one, will they cover a second one as well? Has anyone had insurance cover 2 bands? It just seems strange to me. I was told she would wear it 3 1/2 to 4 months. Now at 3 1/2 months I need another!!! We really never minded the band, it has been great protective gear I just feel annoyed at the whole situation. > Kara > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 6, 2010 Report Share Posted October 6, 2010 Generally you have to pay for the second band only if the child outgrew the first. Most providers will make a new one for free if they didn't make the first one properly. If she hasn't corrected and they don't think it is working then ask them if they can provide the new band free of charge. If it was made properly in the first place, and she hasn't outgrown it, it seems to me they have to admit to a problem. -christine sydney, 4.5 yrs, starband grad > > My daughter is 11 months and has been in her band for 3 1/2 months. It seems like we have made adjustments almost everytime due to ridges or dents forming, and it has always fit pretty loose. She has made some progress but is still pretty flat at the top left side back of her head. Now I am told that there is some concern that this area has not filled out much and I probably need a second band. I questioned whether it ever fit properly to begin with, but of course the answer was yes. It is not like she outgrew it, there is still plenty of room. My insurance covered 80 % of the first one, will they cover a second one as well? Has anyone had insurance cover 2 bands? It just seems strange to me. I was told she would wear it 3 1/2 to 4 months. Now at 3 1/2 months I need another!!! We really never minded the band, it has been great protective gear I just feel annoyed at the whole situation. > Kara > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 12, 2010 Report Share Posted October 12, 2010 Thanks! I called my insurance company and they claim it should be covered. Who knows!! But, at this point we are going to go ahead with it anyway. We have come this far why stop now > > > > My daughter is 11 months and has been in her band for 3 1/2 months. It seems like we have made adjustments almost everytime due to ridges or dents forming, and it has always fit pretty loose. She has made some progress but is still pretty flat at the top left side back of her head. Now I am told that there is some concern that this area has not filled out much and I probably need a second band. I questioned whether it ever fit properly to begin with, but of course the answer was yes. It is not like she outgrew it, there is still plenty of room. My insurance covered 80 % of the first one, will they cover a second one as well? Has anyone had insurance cover 2 bands? It just seems strange to me. I was told she would wear it 3 1/2 to 4 months. Now at 3 1/2 months I need another!!! We really never minded the band, it has been great protective gear I just feel annoyed at the whole situation. > > Kara > > > Quote Link to comment Share on other sites More sharing options...
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