Guest guest Posted March 22, 2004 Report Share Posted March 22, 2004 A friend of mine had a similar argument with her insurance over required contact lenses for her infant grandson with congenital cataracts. She finally won because this is a birth defect and somewhere in the insurance fine print there should be a clause covering necessary DME for cogenital defects (as opposed to just DME). Have your friend APPEAL the decision as high as she needs to go. She also needs to get a copy of the FULL insurance contract rather than the brief synopsis most employers hand out. Likely she can find the appropriate clause herself once she gets the document and she can cite it in her appeals. kj mom to De-Arbra age 16 Quote Link to comment Share on other sites More sharing options...
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