Parents with Blue Cross and Blue Shield Federal Employees Program- PPO

[Guest guest]

Does anyone have this insurance-Blue Cross and Blue Shield Federal

Employees Program- PPO? Is it true that you can't use Cranial

Technolgies? What places are covered? What has been your experience.

i was going to use cT, but now i am afraid that i won't be

rembursed!!!! HELP!!

[Guest guest]

I think it depends on which level of the plan you have. I have BCBS of

NC FEP, the standard option. Cranial Tech was considered out of

network but I still had out of network coverage of 75% after the

deductible. I just had to pay up front and file my own claim (CT can't

file out of network claims) and was reimbursed 75% within a couple of

weeks. If you have the basic option, I don't believe there is any out

of network coverage, so they will not reimburse you for CT. Where are

you located? I had a StarBand option nearby that would have been in

network and covered 90% after the deductible. I think I just called

them and asked if they were in network or out. Otherwise you can do a

search on your state's BCBS FEP website and see what providers come

up. If you need help, let me know.

Jake-20m (tort resolved/rt plagio/DOCBand 12 weeks)

Jordan-4

>

> Does anyone have this insurance-Blue Cross and Blue Shield Federal

> Employees Program- PPO? Is it true that you can't use Cranial

> Technolgies? What places are covered? What has been your

experience.

> i was going to use cT, but now i am afraid that i won't be

> rembursed!!!! HELP!!

>

[Guest guest]

I have the same insurance (Blue Cross/Blue Shield PPO) and the

treatment for my 5 month old son isn't covered either. The specialist

and Cranial Center we visited submitted a letter on our behalf to the

insurance company with detailed analysis and measurements. The purpose

was so the insurance company might consider some form of reimbursement

based on the information in the letter. We're not holding our breath

because our insurance company told us the helmet for plagio (along with

the code they gave us) is considered cosmetic. I am still hoping they

will cover a portion after they receive the letters on our behalf, but

once again, we were told it was " cosmetic " so any reimbursement might

not happen.

Medical devices are covered by our insurance company (such as when my

husband broke his ankle in October), but the helmet is considred

cosmetic! I was stunned!

Perhaps if you continue to call your insurance company and have forms

sumbitted by the doctors you have seen, it might help. Much luck to

you.

G.