Aetna Insurance, Age Limit on Helmets ?

[Guest guest]

Hi everyone

I just posted about my son;s CJ's visit to CT and how he needs a 2nd

helmet according to his new measurements.

I just heard from Cranial Tech's insurance coordinator and she told me

that Aetna only pays for the helmet up until the child is 12 months ?

Has anyone else heard of this ? Do you think I could appeal considering

my ins. put an age limit on Durable Medical Equipment ? I would have to

pay out of pocket for the Doc Band, I think it is 2000 if my ins. wont

cover this

My son wore one Helmet already from 5-10mo of age so it is not like

we are just startin helmet treatment

Any advice would be appreciated!

Thanks

[Guest guest]

I would definitely appeal. I think you have a chance especially if you can show that he wore an ill-fitting helmet. Sorry to hear that. CT has been great with my son and I hope you have a positive experience with them. 9.5 month old son, doc bandcathyl65 <cathyl65@...> wrote: Hi everyoneI just posted about my son;s CJ's visit to CT and how he needs a 2nd helmet according to his new measurements.I just heard from Cranial Tech's insurance

coordinator and she told methat Aetna only pays for the helmet up until the child is 12 months ?Has anyone else heard of this ? Do you think I could appeal considering my ins. put an age limit on Durable Medical Equipment ? I would have to pay out of pocket for the Doc Band, I think it is 2000 if my ins. wont cover thisMy son wore one Helmet already from 5-10mo of age so it is not likewe are just startin helmet treatmentAny advice would be appreciated!Thanks

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[Guest guest]

,

We have AETNA for insurance, and yes their policy does state up to 12 months of age. My daughter wore her first DOCband starting at 10 months of age, which AETNA paid 100% for. When she 13.5 months old, she received her second DOCband.. and AETNA paid 100% for that as well. Her measurements were still within their guidelines, but her age was not, so I was worried they wouldn't pay. I was wondering if maybe the reason why they paid was because she started treatment before 12 months and obviously wasn't finished according to her measurements, so they approved the second helmet?

I don't know, however, I would definitely appeal on the grounds that it is the second helmet after attempting correction before the age of 12 months.

Good luck!

Colleen

Re: Aetna Insurance, Age Limit on Helmets ?

I would definitely appeal. I think you have a chance especially if you can show that he wore an ill-fitting helmet. Sorry to hear that. CT has been great with my son and I hope you have a positive experience with them.

9.5 month old son, doc bandcathyl65 <cathyl65aol> wrote:

Hi everyoneI just posted about my son;s CJ's visit to CT and how he needs a 2nd helmet according to his new measurements.I just heard from Cranial Tech's insurance coordinator and she told methat Aetna only pays for the helmet up until the child is 12 months ?Has anyone else heard of this ? Do you think I could appeal considering my ins. put an age limit on Durable Medical Equipment ? I would have to pay out of pocket for the Doc Band, I think it is 2000 if my ins. wont cover thisMy son wore one Helmet already from 5-10mo of age so it is not likewe are just startin helmet treatmentAny advice would be appreciated!Thanks

Bored stiff? Loosen up...Download and play hundreds of games for free on Games.

[Guest guest]

Colleen,

Thank you so much for this post!! This is very encouraging to hear!

I am going to call my ins. co today to speak with them about this.

I will let you know what I find out!

Thanks again!!!

Mom to CJ- 13mo.

> Hi everyone

> I just posted about my son;s CJ's visit to CT and how he needs

a 2nd

> helmet according to his new measurements.

> I just heard from Cranial Tech's insurance coordinator and she

told me

> that Aetna only pays for the helmet up until the child is 12

months ?

> Has anyone else heard of this ? Do you think I could appeal

considering

> my ins. put an age limit on Durable Medical Equipment ? I would

have to

> pay out of pocket for the Doc Band, I think it is 2000 if my

ins. wont

> cover this

> My son wore one Helmet already from 5-10mo of age so it is not

like

> we are just startin helmet treatment

>

> Any advice would be appreciated!

>

> Thanks

>

>

>

>

>

>

>

> --------------------------------------------------------------------

----------

> Bored stiff? Loosen up...

> Download and play hundreds of games for free on Games.

>

[Guest guest]

You may be able to appeal. I have Atena and my son got his Starband

at 11 mos but, was approved in the 10 mos. range. On Aetna's site

they give the critiera about covering the band & one of them is the

age range of 4-12 mos. Here is the link to the Atena page

http://www.aetna.com/cpb/medical/data/300_399/0379.html

Kim

mom to 4.12.06

Starband 3.14.07

NJ

> Hi everyone

> I just posted about my son;s CJ's visit to CT and how he needs a

2nd

> helmet according to his new measurements.

> I just heard from Cranial Tech's insurance coordinator and she

told me

> that Aetna only pays for the helmet up until the child is 12

months ?

> Has anyone else heard of this ? Do you think I could appeal

considering

> my ins. put an age limit on Durable Medical Equipment ? I would

have to

> pay out of pocket for the Doc Band, I think it is 2000 if my ins.

wont

> cover this

> My son wore one Helmet already from 5-10mo of age so it is not like

> we are just startin helmet treatment

>

> Any advice would be appreciated!

>

> Thanks

>

>

>

>

>

>

>

> ---------------------------------

> Bored stiff? Loosen up...

> Download and play hundreds of games for free on Games.

>

[Guest guest]

Kim,

This website was very helpful! Thanks! I noticed they have a clause

too that says that as long helmet therapy is INITIATED at 4-12mo of

age. I take this to mean that since my son has been doing this since

5 mo that they should cover it. I spoke with my ins. co this morning

and they told me to have CT call a spec.# to pre-certify the helmet.

I left msg for Ins.Coordinator at CT this morning and am waiting for

a call back to give her the info

Wish us luck!!

> > Hi everyone

> > I just posted about my son;s CJ's visit to CT and how he needs a

> 2nd

> > helmet according to his new measurements.

> > I just heard from Cranial Tech's insurance coordinator and she

> told me

> > that Aetna only pays for the helmet up until the child is 12

> months ?

> > Has anyone else heard of this ? Do you think I could appeal

> considering

> > my ins. put an age limit on Durable Medical Equipment ? I would

> have to

> > pay out of pocket for the Doc Band, I think it is 2000 if my ins.

> wont

> > cover this

> > My son wore one Helmet already from 5-10mo of age so it is not

like

> > we are just startin helmet treatment

> >

> > Any advice would be appreciated!

> >

> > Thanks

> >

> >

> >

> >

> >

> >

> >

> > ---------------------------------

> > Bored stiff? Loosen up...

> > Download and play hundreds of games for free on Games.

> >

>