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Re: Paying for Helmet

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Hi:

My insurance covered Abby's 1st STARband 50%, they considered it

durable medical equipment. We have since switched to the DOC band,

which they refused to cover any of, becuz they already paid for one.

I have fought & fought and gotten no where! If you do have problems

with your ins., keep fighting and fighting and fighting. Right now

I'm fighting with my silly dental ins., they won't cover my impacted

wisdom tooth extraction or the anesthesia for it! I'm soooo mad. I

cannot relay my disgust for insurance companies right now.

As far as him adapting to it, it shouldn't be a problem, especially

with as young as he is. I cannot imagine a baby that young even

realizing it's there, Abby started her treatment at 8 mos. and it was

NO problem whatsoever. I havent' heard of too many parents

experiencing problems with their baby accepting the band. Good luck!

Debbie Abby's mom 3/1/00

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I am in the very early stages of trying to get our insurance to pay

for this, but one thing which has already come up is measurements.

Apparently Aetna has just released new guidelines for payment whereby

approval depends upon mathmatical computations to determine how

severe the plagio is. They have said that they will only pay for a

helmet in cases where the asymmetry between the high spot and low

spot is greater than 6mm. Our doctor therefore suggested that we

send them some measurements from nose to ear on each side, to show

the asymmetry is that great. It might be worth trying to get that

added to your letters, but I guess it depends on the insurance

company.

Good luck with it anyway.

Kimberley

> Hi. I am new to this group. My son Henry has a mild case of

> plagiocephaly. We are about to embark on helmet therapy. My

question

> is this: have any of you been successful in getting your insurance

to

> pay for the helmet? Aside from being about to scream at the

insurance

> company...We sent them two letters of medical necessity and they

lost

> both of them....I am concerned that they won't pay for it. Is there

> anything anyone can recommend as far as this goes. It is a sizeable

> expense ($1400) and I would like to get it covered if at all

> possible. I wonder if anyone can offer advice. Also--how well

> tolerated is the helmet. My son is only 3 months old and I am

worried

> that he will have a problem adapting to it and that it will be

> uncomfortable. Thanks in advance for your help. AnnesHenry

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