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Hello to all you Tricare parents. I just wanted to let you know that

we are fighting Foundation Health in Louisiana. That is who our

Tricare is through. Also, yesterday I went to a wives meeting and

talked with some of the commanders wives here (Barksdale AFB). I am

hoping to get them along with other important wives in the are--we

have the head of 8th Air Force here--to help me by writing letters to

Tricare or also talking to their husbands to see what they can do. I

am hoping since I am on the Officers Spouses Board here that I will

have some luck getting some Generals wives to help me in my fight. I

talked to one wife and she was very upset that Tricare won't cover

the treatment for Ainsley. She said that it was insane for them to

cover some treatment for children and not other. I have been talking

to everyone I know in my neighborhood--I live on base-- and hopefully

we can get more people than just ourselves involved in getting this

approved. Like I said Strength in Numbers and once one gets approved

we all have a much better chance. Well good luck to all and lets try

and keep eachother informed on the progress we make to ensure that we

all get approved from Tricare!!!

Porterfield mom to Ainsley

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  • 4 months later...

my name is and I am not sure if I talked to you in the

past. My son had craniosynostosis but because we went to Missouri for

surgery he had to get three helmets. I fought Tricare for about six months

to cover the entire thing. I finally got it covered out of 17,000.00 we only

had to pay 246.00 and that was co-pay and cost-share. Now the helmets were a

question all the way up to the end. They did pay for them under a special

code and we did have to pay a little costshare like I said around 246.00. I

talked to them about plagio and helmets and they said they never cover it.

Also to hear that you are in the Atlanta area means that you have the same

Humana that we fought. I will say that what got us approved was involving my

husbands command, our Congressman who is strong on military and Tricare

issues, and contacting the National Military Family Association. They were

the ones that got my ball rolling to inform big wigs in DC what was

happening. I have spoke to many military families and this needs to change.

If you need anything let me know.

Pitchke

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, please check out www.nmfa.org they are the ones that got my problem

with 's surgery resolved they know ALOT of people in DC. I think that

you need to get a group of military families who have or are dealing with

this to help you fight and get this changed. I remember telling them and a

lady at the Marine Corp Times who also writes for all of the Times about many

of you being denied helmets for your babies. Check it out and if I can help

more let me know.

Pitchke

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  • 5 months later...
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I'm still trying to post the letter I have. I scanned it and tried to post it but it ended up being huge! (over 1,000 kb) I would like to get it posted to others can see what this external review company had to say.Marci:

Send it to me, and I'll see what I can do!

Kendra in CanadaFor more plagio info, go towww.plagiocephaly.org/support...

----- Original Message -----

From: marcisch@...

Plagiocephaly

Sent: Thursday, May 31, 2001 7:19 AM

Subject: Re: TRICARE

Tom,I do not have TRICARE, but I sympathize with your situation since I had to fight my insurance co for 7 months to get coverage. We only got coverage after our case was sent to an external review board. I have been trying to post the letter I got from the external review company with no luck. (Kendra or Beck maybe you can help me) The letter I received that overtuned the denial states in one paragraph the following:"Review of the medical literature and current clinical practice across the United States (including the letter dated 09/13/2000 from S. Kahan, Deputy Director for Regulations and Policy, Center for Devices and Radiological Health, Food and Drug Administration) indicates that this patient should be evaluated for a molded cranial helmet for treatment of the left posterior plagiocephaly condition."I would really like to see the letter from S. Kahan that is referenced in that paragraph as it was appartenly influential in overturning my insurance company's decision to non-cover based on the therapy being cosmetic!! Does anyone have any ideas on how we might get our hands on this letter???? I think it would help many of us in our fight to have a letter written by someone in the Food and Drug Adminstration!!I'm still trying to post the letter I have. I scanned it and tried to post it but it ended up being huge! (over 1,000 kb) I would like to get it posted to others can see what this external review company had to say.Sorry this is so long, but the subject of health insurance is very near and dear to my heart. (I work for a company that administers life and health insurance policies)Marci (Mom to )OklahomaFor more plagio info

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