Re: Excited But Worried

[Guest guest]

Hi Amy,

Congratulations on getting your prescription! It really is worth it! My daughter got her DOC band at 7 months old and she wore it for 15 weeks. She had right plagio. We saw great correction! My husband is active duty army and have Tricare Prime. We were told up front that the band would not be covered, but opted to band anyways. We went with Care Credit and charged the $3300 and figured we would appeal later. I ran out of time and never did file my appeal, but I know of some people who are on their 3rd, 4th, even 5th appeals. I totally agree that the bands are not covered because they are considered cosmetic! We have a 14 yr old son who wore braces, but those were covered 80%! I think the band should be covered at LEAST 80%, but what do I know...

Anyways, sorry to get so out of sorts, but it bothers me so much!!!

We did go back and forth on the decision to band, but in the end figured it was the best thing to do for her. I don't regret it at all!! She got her band about a week before my husband deployed, so he was able to decorate her band. We kept all the original stickers on it, just because her dad did it and they stayed on for the entire time!! (well, maybe I replaced 1 or 2). I think this is one of the best decisions you will ever make. The time goes by so fast, and when my daughter finally graduated, it was so strange to see her with a naked head! I actually missed it. When I would pick her up from daycare or church nursery, I always had to look twice because I was looking for her banded head!! Good luck to you! This is the best group! Everyone is so helpful. Please let me know if you need anything!

Toni

Killeen, Texas

Mom to Amelia (13 months) DOC Band grad 2/22/08

Excited But Worried

Hi~I posted questions before about positioning vs. helmet. My son is almost 8 months old. Yesterday we went to a follow up appt. for my son's plagio and they gave us a prescription for the Starband. I was so excited b/c that is what I really wanted. We have our casting appt. next friday and then our follow-up appt. to get the band is two weeks later. However, I am worried b/c I dont think it looks promising with our insurance. We have 's Point (a ticare prime option) for active duty families. They asked me if I wanted to wait for the authorization or go ahead with the banding. I opted to go ahead with the banding b/c he is already almost 8 months old. I am skepticle that it will be authorized anyways. I think it is rediculous that insurance pays for braces and such but won't pay for cranial remolding helmets. I was hoping that they would charge less if insurance wouldn't cover it. The cost is 3500.00. So I am worried about the money, but how can I not do this for my child when I know he needs it. Then in the back of my mind I am thinking maybe it will correct itself, but then maybe not. My husband is deployed and my family in chicago so I am doing this by myself. So my questions are:Has anyone ever second guessed their decision befor they go through with it?Is anyone familiar with martin's point or tricare?Do you always see results with banding? He has brachy and plagio.Is 3500.00 reasonable cost?How long does it usually take for authorization?Thankyou,Amy (aiden 8 mo., tort, plagio and brachy)Watertown NY

[Guest guest]

Hi there! I am originally from Buffalo NY. I drove myself crazy going between giving it more time or banding. I felt that I was not given a chance to let it self correct, b/c my ped said that it would "round out on its own". I also drove myself crazy asking a ton of questions about starband vs doc, lenght of tx and etc. I was actually still second guessing my decision when my son was being measured for his helmet. The cost here in San Diego is $2850.00. I went ahead and paid for the band and will wait to be reimbursed or prepare to fight with my insurance. I have BCBS and I had to use their provider to be covered. My Orto stated that

authorization can take 3-4 weeks and we may get a denial. My son has severe plagio (18mm assem) and sleight bracy. I got opinions at 2 different clinics and both said that it will not self correct on its own. my son is 5 months one week. Good Luck. Let us know if you need anything. i thank your hubby for his service to this country. This board is very informative and supportive.

Excited But Worried

Hi~I posted questions before about positioning vs. helmet. My son is almost 8 months old. Yesterday we went to a follow up appt. for my son's plagio and they gave us a prescription for the Starband. I was so excited b/c that is what I really wanted. We have our casting appt. next friday and then our follow-up appt. to get the band is two weeks later. However, I am worried b/c I dont think it looks promising with our insurance. We have 's Point (a ticare prime option) for active duty families. They asked me if I wanted to wait for the authorization or go ahead with the banding. I opted to go ahead with the banding b/c he is already almost 8 months old. I am skepticle that it will be authorized anyways. I think it is rediculous that insurance pays for braces and such but won't pay for cranial remolding helmets. I was hoping that they would charge less if insurance wouldn't cover it. The cost

is 3500.00. So I am worried about the money, but how can I not do this for my child when I know he needs it. Then in the back of my mind I am thinking maybe it will correct itself, but then maybe not. My husband is deployed and my family in chicago so I am doing this by myself. So my questions are:Has anyone ever second guessed their decision befor they go through with it?Is anyone familiar with martin's point or tricare?Do you always see results with banding? He has brachy and plagio.Is 3500.00 reasonable cost?How long does it usually take for authorization?Thankyou,Amy (aiden 8 mo., tort, plagio and brachy)Watertown NY

[Guest guest]

Hi Killeen~

Thankyou for the response and support. It sounds like you were happy that you banded her. Was it hard going through the process without your husband there for the support? My husband doesn't know yet that it probably won't be covered. Did you see good results with the band? I have noticed some facial assymetry and his one eye buldges. Do you know if the band will help that? I just can't wait to get the process started and I think that I will feel better. You are right this group is helpful b/c I have learned so much already.

Thanks,

Amy

Watertown NY

Aiden 8mo (tort, right plagio, brachy)

Emma 3 years old

Excited But Worried

Hi~I posted questions before about positioning vs. helmet. My son is almost 8 months old. Yesterday we went to a follow up appt. for my son's plagio and they gave us a prescription for the Starband. I was so excited b/c that is what I really wanted. We have our casting appt. next friday and then our follow-up appt. to get the band is two weeks later. However, I am worried b/c I dont think it looks promising with our insurance. We have 's Point (a ticare prime option) for active duty families. They asked me if I wanted to wait for the authorization or go ahead with the banding. I opted to go ahead with the banding b/c he is already almost 8 months old. I am skepticle that it will be authorized anyways. I think it is rediculous that insurance pays for braces and such but won't pay for cranial remolding helmets. I was hoping that they would charge less if insurance wouldn't cover it. The cost

is 3500.00. So I am worried about the money, but how can I not do this for my child when I know he needs it. Then in the back of my mind I am thinking maybe it will correct itself, but then maybe not. My husband is deployed and my family in chicago so I am doing this by myself. So my questions are:Has anyone ever second guessed their decision befor they go through with it?Is anyone familiar with martin's point or tricare?Do you always see results with banding? He has brachy and plagio.Is 3500.00 reasonable cost?How long does it usually take for authorization?Thankyou,Amy (aiden 8 mo., tort, plagio and brachy)Watertown NY

[Guest guest]

Hello~

I feel the same way about driving myself crazy! This situation definitely can. I noticed you paid $2850. and I was quoted 3500.00. Do you know why there is such a difference in cost? Where we are located I don't have the option of really going anywhere else. This orthotist was referred by our craniofacial and he does all of northern ny. The next closest CT is in NJ 5 hours away and they are 3000.00 with military discount, but that is too far of a drive.

Thanks,

amy

aiden 8 mo (tort, right plagio, brachy)

emma 3 years old

Excited But Worried

Hi~I posted questions before about positioning vs. helmet. My son is almost 8 months old. Yesterday we went to a follow up appt. for my son's plagio and they gave us a prescription for the Starband. I was so excited b/c that is what I really wanted. We have our casting appt. next friday and then our follow-up appt. to get the band is two weeks later. However, I am worried b/c I dont think it looks promising with our insurance. We have 's Point (a ticare prime option) for active duty families. They asked me if I wanted to wait for the authorization or go ahead with the banding. I opted to go ahead with the banding b/c he is already almost 8 months old. I am skepticle that it will be authorized anyways. I think it is rediculous that insurance pays for braces and such but won't pay for cranial remolding helmets. I was hoping that they would charge less if insurance wouldn't cover it. The cost

is 3500.00. So I am worried about the money, but how can I not do this for my child when I know he needs it. Then in the back of my mind I am thinking maybe it will correct itself, but then maybe not. My husband is deployed and my family in chicago so I am doing this by myself. So my questions are:Has anyone ever second guessed their decision befor they go through with it?Is anyone familiar with martin's point or tricare?Do you always see results with banding? He has brachy and plagio.Is 3500.00 reasonable cost?How long does it usually take for authorization?Thankyou,Amy (aiden 8 mo., tort, plagio and brachy)Watertown NY

[Guest guest]

Hi Amy,

Sorry it has taken so long to respond! The whole banding process was not too bad. We got our daughter casted and her band in right before my husband deployed, so he was able to help me out with the whole process. It was a little rough in the beginning after he left to make it to the appointments since we had an hours drive to CT in Austin. Amelia adjusted wonderfully to her band, we never really had too many problems with red spots, itching, etc.

My daughter started off at 13 mm asymmetry and ended with 4 mm. She does look different, it really does help. I'm not sure about the eye bulge, but I think the banding will help with it. Amelia has some pics in the Plagio folder "A". I hope this helps a little bit! Good luck and if you just want to chat, just let me know, I'm usually home.

Toni

Excited But Worried

Hi~I posted questions before about positioning vs. helmet. My son is almost 8 months old. Yesterday we went to a follow up appt. for my son's plagio and they gave us a prescription for the Starband. I was so excited b/c that is what I really wanted. We have our casting appt. next friday and then our follow-up appt. to get the band is two weeks later. However, I am worried b/c I dont think it looks promising with our insurance. We have 's Point (a ticare prime option) for active duty families. They asked me if I wanted to wait for the authorization or go ahead with the banding. I opted to go ahead with the banding b/c he is already almost 8 months old. I am skepticle that it will be authorized anyways. I think it is rediculous that insurance pays for braces and such but won't pay for cranial remolding helmets. I was hoping that they would charge less if insurance wouldn't cover it. The cost is 3500.00. So I am worried about the money, but how can I not do this for my child when I know he needs it. Then in the back of my mind I am thinking maybe it will correct itself, but then maybe not. My husband is deployed and my family in chicago so I am doing this by myself. So my questions are:Has anyone ever second guessed their decision befor they go through with it?Is anyone familiar with martin's point or tricare?Do you always see results with banding? He has brachy and plagio.Is 3500.00 reasonable cost?How long does it usually take for authorization?Thankyou,Amy (aiden 8 mo., tort, plagio and brachy)Watertown NY