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Re: AFO wearers question

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Terry Little

Office of the Director

Center for Scientific Review

Bethesda, MD 20892-7776

301/435-1111

littlet@...

-----Original Message-----

From: Gretchen Glick [mailto:liliwigg@...]

Sent: Tuesday, July 17, 2001 12:25 PM

ers at groups

Subject: [] AFO wearers question

For those of you who wear AFOs, tell me something:

1) How often do you go in for a checkup? Once a year, never, when

needed, etc? Rarely, only when I have a problem like they need new padding.

2) Those of you with children wearing AFOs, how often do growing

children's AFOs need to be refitted or replaced? A few months, several

times a year, etc? NA

3) If you have an HMO for health insurance, how are AFOs treated when

it comes to 'payment' for them? My health plan, Kaiser, does not cover

anything -- splints, padding, not anything.

4) If you have private health insurance, how are AFOs treated when it

comes to 'payment' time? NA

5) If you get your AFOs through MDA, is the 5 year period a too long of

a wait to get changes or adjustments made? DEFINITELY

Naturally, not being an AFO wearer, I am clueless, so fill me in,

please.

~ Gretchen

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----- Original Message -----

From: Gretchen Glick

ers at groups

Sent: Tuesday, July 17, 2001 12:25 PM

Subject: [] AFO wearers question

For those of you who wear AFOs, tell me something:

1) How often do you go in for a checkup? Once a year, never, when

needed, etc?

When needed

2) Those of you with children wearing AFOs, how often do growing

children's AFOs need to be refitted or replaced? A few months, several

times a year, etc?

N/A but would depend on child's growth.

3) If you have an HMO for health insurance, how are AFOs treated when

it comes to 'payment' for them?

N/A

4) If you have private health insurance, how are AFOs treated when it

comes to 'payment' time?

Can't speak for " private " but my group insurance will pay for AFO's ,

according to a " usual, customary, and reasonable charge " list. They will

not pay for REPAIR, but will pay for " modification " , so it depends on how it

is listed. Medicare pays according to " schedule " .

5) If you get your AFOs through MDA, is the 5 year period a too long of

a wait to get changes or adjustments made?

Only assistance MDA gave was for the clinic doctor to order them, I had to

pay above Medicare out of my pocket as I had not reached my deductable for

insurance. I seem to recall seeing that MDA's policy is very 2 years for

AFO's. According to their literature, the max payment is approved yearly.

Also according to their site they will ay for repairs.

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I JUST GOT OFF THE PHONE WITH MDA -- THE WAIT IS FOR 5 YEARS (UP TO $2,000

IS ALLOWABLE) -- MUCH TOO LONG A TIME!

Terry Little

littlet@...

-----Original Message-----

From: Lamar son [mailto:lls@...]

Sent: Tuesday, July 17, 2001 1:46 PM

Subject: Re: [] AFO wearers question

----- Original Message -----

From: Gretchen Glick

ers at groups

Sent: Tuesday, July 17, 2001 12:25 PM

Subject: [] AFO wearers question

For those of you who wear AFOs, tell me something:

1) How often do you go in for a checkup? Once a year, never, when

needed, etc?

When needed

2) Those of you with children wearing AFOs, how often do growing

children's AFOs need to be refitted or replaced? A few months, several

times a year, etc?

N/A but would depend on child's growth.

3) If you have an HMO for health insurance, how are AFOs treated when

it comes to 'payment' for them?

N/A

4) If you have private health insurance, how are AFOs treated when it

comes to 'payment' time?

Can't speak for " private " but my group insurance will pay for AFO's ,

according to a " usual, customary, and reasonable charge " list. They will

not pay for REPAIR, but will pay for " modification " , so it depends on how it

is listed. Medicare pays according to " schedule " .

5) If you get your AFOs through MDA, is the 5 year period a too long of

a wait to get changes or adjustments made?

Only assistance MDA gave was for the clinic doctor to order them, I had to

pay above Medicare out of my pocket as I had not reached my deductable for

insurance. I seem to recall seeing that MDA's policy is very 2 years for

AFO's. According to their literature, the max payment is approved yearly.

Also according to their site they will ay for repairs.

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Hi Gretchen,

Owen here,

1) How often do you go in for a checkup? Once a year, never, when

needed, etc?

When ever needed. Thats usually 4 or 5 years.

2) Those of you with children wearing AFOs, how often do growing

children's AFOs need to be refitted or replaced? A few months, several

times a year, etc?

N/A

3) If you have an HMO for health insurance, how are AFOs treated when

it comes to 'payment' for them?

HMO Illinois pays 100%

4) If you have private health insurance, how are AFOs treated when it

comes to 'payment' time?

N/A

5) If you get your AFOs through MDA, is the 5 year period a too long of

a wait to get changes or adjustments made?

N/A

Naturally, not being an AFO wearer, I am clueless, so fill me in,

please.

~ Gretchen

Happy Trails

Owen

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In a message dated 7/17/2001 11:02:37 AM Pacific Daylight Time, lls@...

writes:

> For those of you who wear AFOs, tell me something:

>

> 1) How often do you go in for a checkup? Once a year, never, when

> needed, etc?

> When needed

>

>

> 2) Those of you with children wearing AFOs, how often do growing

> children's AFOs need to be refitted or replaced? A few months, several

> times a year, etc?

>

> Every 6 months unless they break before 6 months.

>

> 3) If you have an HMO for health insurance, how are AFOs treated when

> it comes to 'payment' for them?

>

> N/A

>

> 4) If you have private health insurance, how are AFOs treated when it

> comes to 'payment' time?

>

> My insurance company Blue Cross pays for the AFOs 100%. They cover

> repairs and modifications.

>

> 5) If you get your AFOs through MDA, is the 5 year period a too long of

> a wait to get changes or adjustments made?

>

> N/A

>

>

>

>

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hi Gretchen,

Dee here

1) How often do you go in for a checkup? Once a year, never, when

needed, etc?

every year

2) Those of you with children wearing AFOs, how often do growing

children's AFOs need to be refitted or replaced? A few months,

several

times a year, etc?

my son doesn't wear them. dr feels his is very mild.

3) If you have an HMO for health insurance, how are AFOs treated

when

it comes to 'payment' for them?

n/a

4) If you have private health insurance, how are AFOs treated when

it

comes to 'payment' time?

n/a

5) If you get your AFOs through MDA, is the 5 year period a too

long of

a wait to get changes or adjustments made?

i've had my for eight years. found out this past week at check up

can get new pair every five years if need be. adjustments wwhen

needed.

God bless all

Dee

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