Guest guest Posted April 11, 2006 Report Share Posted April 11, 2006 We have Cigna insurance and I know they put the DOC band under " External Prosthetic Appliances " . With my plan they only pay $1,000 maximum per year in that category. Still it was better than nothing. Plus they are in-network so CT took off $500 from their price which also helped. Audrey 8 mo, DOC Band 1/23/2006 --- gradygirl79 <gradygirl79@...> wrote: > We have Cigna, and I don't think they'll pay for any > of the cost. > Has anyone had luck getting them to pay when the > Plagio is mild? > > I am taking a shot in the dark, but I thought I'd > ask and see! > > > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 11, 2006 Report Share Posted April 11, 2006 Audrey, How severe was your DC case? My DD is mild. only 5mm ear assymetry. I am going to get Hanger to run our Ins. card just to see if they'll pay any. We have Cigna PPO. Audrey <isdfc@...> wrote: We have Cigna insurance and I know they put the DOCband under "External Prosthetic Appliances". With myplan they only pay $1,000 maximum per year in thatcategory. Still it was better than nothing. Plusthey are in-network so CT took off $500 from theirprice which also helped.Audrey 8 mo, DOC Band 1/23/2006--- gradygirl79 <gradygirl79@...> wrote:> We have Cigna, and I don't think they'll pay for any> of the cost.> Has anyone had luck getting them to pay when the> Plagio is mild?> > I am taking a shot in the dark, but I thought I'd> ask and see!> > > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 11, 2006 Report Share Posted April 11, 2006 We have Cigna's POS Open Access Plan. Your messages made me decide to check to make sure everything is being processed correctly. The rep at Cigna said yes, it is all going to be paid for my twins. Hayden has a mild case, but Lane's is severe. He also said that if either one needs a second helmet it will cover it as well. I have heard that there are many different plans, though. I hope you are all covered as well. Amy > > We have Cigna, and I don't think they'll pay for any > > of the cost. > > Has anyone had luck getting them to pay when the > > Plagio is mild? > > > > I am taking a shot in the dark, but I thought I'd > > ask and see! > > > > > > > > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 11, 2006 Report Share Posted April 11, 2006 Thanks! I'm glad to hear they are covering both of yours! That's a big chunk of change out of pocket! mlekodaja <amlekodaj@...> wrote: We have Cigna's POS Open Access Plan. Your messages made me decide to check to make sure everything is being processed correctly. The rep at Cigna said yes, it is all going to be paid for my twins. Hayden has a mild case, but Lane's is severe. He also said that if either one needs a second helmet it will cover it as well. I have heard that there are many different plans, though. I hope you are all covered as well. Amy> > We have Cigna, and I don't think they'll pay for any> > of the cost.> > Has anyone had luck getting them to pay when the> > Plagio is mild?> > > > I am taking a shot in the dark, but I thought I'd> > ask and see!> > > > > > > > > __________________________________________________> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2006 Report Share Posted April 12, 2006 He was moderate to severe with 8mm asymmetry. I have the Cigna Open Access Plus High Option plan. It sounds like Cigna pays the full amount for some people but limited amount for others. I'd be curious to know why that is. Audrey --- Grady <gradygirl79@...> wrote: > Audrey, > How severe was your DC case? > My DD is mild. only 5mm ear assymetry. I am going > to get Hanger to run our Ins. card just to see if > they'll pay any. We have Cigna PPO. > > > > Audrey <isdfc@...> wrote: > We have Cigna insurance and I know they put the > DOC > band under " External Prosthetic Appliances " . With > my > plan they only pay $1,000 maximum per year in that > category. Still it was better than nothing. Plus > they are in-network so CT took off $500 from their > price which also helped. > > Audrey > 8 mo, DOC Band 1/23/2006 > > --- gradygirl79 <gradygirl79@...> wrote: > > We have Cigna, and I don't think they'll pay for > any > > of the cost. > > Has anyone had luck getting them to pay when the > > Plagio is mild? > > > > I am taking a shot in the dark, but I thought I'd > > ask and see! > > > > > > > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2006 Report Share Posted April 12, 2006 I don't understand it either. I called Cigna one time, and they told me that it wouldn't be covered. I guess that now that I have seen a few Dr.s maybe I should call them back and try again. I'm curious to know why thy won't pay for it either. I guess they say it's "cosmetic", but what kid wants to grow up with a misshapen head???? Audrey <isdfc@...> wrote: He was moderate to severe with 8mm asymmetry.I have the Cigna Open Access Plus High Option plan. It sounds like Cigna pays the full amount for somepeople but limited amount for others. I'd be curiousto know why that is.Audrey--- Grady <gradygirl79@...> wrote:> Audrey,> How severe was your DC case?> My DD is mild. only 5mm ear assymetry. I am going> to get Hanger to run our Ins. card just to see if> they'll pay any. We have Cigna PPO.> > > > Audrey <isdfc@...> wrote:> We have Cigna insurance and I know they put the> DOC> band under "External Prosthetic Appliances". With> my> plan they only pay $1,000 maximum per year in that> category. Still it was better than nothing. Plus> they are in-network so CT took off $500 from their> price which also helped.> > Audrey> 8 mo, DOC Band 1/23/2006> > --- gradygirl79 <gradygirl79@...> wrote:> > We have Cigna, and I don't think they'll pay for> any> > of the cost.> > Has anyone had luck getting them to pay when the> > Plagio is mild?> > > > I am taking a shot in the dark, but I thought I'd> > ask and see!> > > > > > > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2006 Report Share Posted April 12, 2006 Here is the Cigna policy link. It was recently updated - 3/15/06. http://www.cigna.com/health/provider/medical/procedural/coverage_positions/medical/mm_0056_coveragepositioncriteria_cranial_orthotic_devices.pdf I'm sure the difference coverage levels have to do with the company contracts for amount of service provided and co-pay specifics. Employers can dictate how much they will pay versus their employees. na, DOC Grad X2, Feb 04, Tort ResolvedKiersten, DOC Grad 4/4/06, Tort Resolvedwww.thefilyaws.com/plagio/plagio.html> > > We have Cigna, and I don't think they'll pay for> > any> > > of the cost.> > > Has anyone had luck getting them to pay when the> > > Plagio is mild?> > > > > > I am taking a shot in the dark, but I thought I'd> > > ask and see!> > > > > > > > > > > > > __________________________________________________> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2006 Report Share Posted April 12, 2006 Thanks a bunch! <monicash@...> wrote: Here is the Cigna policy link. It was recently updated - 3/15/06. http://www.cigna.com/health/provider/medical/procedural/coverage_positions/medical/mm_0056_coveragepositioncriteria_cranial_orthotic_devices.pdf I'm sure the difference coverage levels have to do with the company contracts for amount of service provided and co-pay specifics. Employers can dictate how much they will pay versus their employees. na, DOC Grad X2, Feb 04, Tort ResolvedKiersten, DOC Grad 4/4/06, Tort Resolvedwww.thefilyaws.com/plagio/plagio.html> > > We have Cigna, and I don't think they'll pay for> > any> > > of the cost.> > > Has anyone had luck getting them to pay when the> > > Plagio is mild?> > > > > > I am taking a shot in the dark, but I thought I'd> > > ask and see!> > > > > > > > > > > > > __________________________________________________> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2006 Report Share Posted April 12, 2006 I'm not sure about your insurance co., but our doc told us that most times they can write a letter to your insurance co, telling them that it is " necissary medical equipment " and since it is recommended by your doc as necissary, they will most times cover it. Talk to your doc (pref the one who recommended the band) and ask them what they recommend. Good luck! > > > We have Cigna, and I don't think they'll pay for > > any > > > of the cost. > > > Has anyone had luck getting them to pay when the > > > Plagio is mild? > > > > > > I am taking a shot in the dark, but I thought I'd > > > ask and see! > > > > > > > > > > > > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 13, 2006 Report Share Posted April 13, 2006 Well, the lady at Hanger called my Ins. co. yesterday, and they were so annoying. They gave her another number to call, and so she did. Wellll, apparently they told her that Cigna would have to contact me within a week, and set up an appmt. to send a specialist to OUR HOUSE to evaluate Chloe. Ummm....isn't that why I took her to a Neurosurgeon??? What would Cigna know that a NEUROSURGEON wouldn't? I told her not to even bother, b/c I know all they'd do is give us the run around, and then deny coverage. It would be another month before we'd know anything prob. and we don't have another month to wait. Chloe is already 9 months old. Urghhhh! I hate Cigna! canta79leslie <canta79@...> wrote: I'm not sure about your insurance co., but our doc told us that most times they can write a letter to your insurance co, telling them that it is "necissary medical equipment" and since it is recommended by your doc as necissary, they will most times cover it. Talk to your doc (pref the one who recommended the band) and ask them what they recommend. Good luck!> > > We have Cigna, and I don't think they'll pay for> > any> > > of the cost.> > > Has anyone had luck getting them to pay when the> > > Plagio is mild?> > > > > > I am taking a shot in the dark, but I thought I'd> > > ask and see!> > > > > > > > > > > > > __________________________________________________> Quote Link to comment Share on other sites More sharing options...
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