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Hi ,

Thank you for a great update! This is such good news! I love reading

happy insurance stories. When will your son be getting his helmet?

Please keep us posted.

> After tearing up the internet searching for articles on

plagiocephaly

> and using a couple of letters off of this site for help, I wrote my

> appeal letter to the insurance company. Today, I found out that my

> denial was overturned and they are going to pay for my sons

helmet.

> What a blessing since I might be losing my job in a couple of

weeks.

>

> I can't thank everyone enough for posting info. My letter wouldn't

> of been the same with out it.

>

> Thanks again,

>

>

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,

Congratulations! Great news!! Good for you for sticking with it!

Marci (Mom to )

Oklahoma

> After tearing up the internet searching for articles on

plagiocephaly

> and using a couple of letters off of this site for help, I wrote my

> appeal letter to the insurance company. Today, I found out that

my

> denial was overturned and they are going to pay for my sons

helmet.

> What a blessing since I might be losing my job in a couple of

weeks.

>

> I can't thank everyone enough for posting info. My letter

wouldn't

> of been the same with out it.

>

> Thanks again,

>

>

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  • 5 months later...
Guest guest

Hey, I'm sure you will be fine. I did not have drains either, I guess I wish in hindsight that my doctor had used them--I wonder sometimes if that is why it took me so long to heal if I had bacteria in my body. I know I had an infection because I had capsular contracture as well as feverish breasts, and Dr. Blais said my implants were contaminated with mycoplasma. At any rate, I did heal Lena, it just took me 3 years to start feeling really good again! I do have Hashimoto's now, and I wasn't diagnosed with that until last year...nna has said that she heard it was related to some kind of bacterial infection or maybe viral, not sure, but she has it too and hopefully hers is going into remission.

At any rate, I just wanted to say that you can heal even tho you didn't have drains. Don't worry about it too much.

Patty

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Who is your insurance company? I have fought Blue Cross of Ca for the last 6 months, my doctor originally tried to refer me out and they said no because it was not effecting my everyday life. I then wrote back about my symptoms and some doctors and nurses reviewed the case and again agreed that since I did not have any hardening and all my other symptoms were not from implants. I can have a private party review the case and have the review still, I can send in now that I have paid for my explant. I am not sure if they will pay for it..... my symptoms have not gone away yet, it has only been 9 days and I figure it will take some time. Does anyone have any suggestions as far as what I can write to this private review board before my 6 month is up in Sept.....thank you...

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

From: lena_beck2004

Sent: Wednesday, July 09, 2003 10:28 PM

Subject: Insurance company

I was surprised that they paid for it. I really think that the implant makers should pay for it. I'm kind of worrying about why she didn't put a drain in. Hope that doesn't turn out to be a mistake!> Awesome! Great insurance company!> ----- Original Message ----- > From: lena_beck2004 > > Sent: Wednesday, July 09, 2003 10:14 PM> Subject: Re: Hello. I had explant surgery yesterday. I am amazed at how good I'm feeling.> > > Patty,> Hi. Yes, I'm certain my scar capsules were removed. I saw a copy of > the surgery report and the implants are being sent for lab testing > because my insurance company had to pay for the surgery and they > demanded that the implants be removed en bloc with capsules removed.

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You might want to find out some tips from Dr. Kolb. She says she knows how the insurance industry works with breast implant cases, and she always gets it covered. Maybe she can give you some ideas. Mine was covered too, my explanting doc got it covered in 1998, unheard of at that time, but his tactic was to neglect to mention in his letter that my implants were saline, and he also said that I had BAker IV contractures, which the insurance industry views as a potential liability since it obscures detection of cancer.

Patty

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

From:

Sent: Thursday, July 10, 2003 7:44 AM

Subject: Re: Insurance company

Who is your insurance company? I have fought Blue Cross of Ca for the last 6 months, my doctor originally tried to refer me out and they said no because it was not effecting my everyday life. I then wrote back about my symptoms and some doctors and nurses reviewed the case and again agreed that since I did not have any hardening and all my other symptoms were not from implants. I can have a private party review the case and have the review still, I can send in now that I have paid for my explant. I am not sure if they will pay for it..... my symptoms have not gone away yet, it has only been 9 days and I figure it will take some time. Does anyone have any suggestions as far as what I can write to this private review board before my 6 month is up in Sept.....thank you...

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Patty,

I'm sorry to hear that you have Hashimoto's. I know that that is a

terrible illness. My mom has had implants for about 30 years, first

the silicone and now the saline. She is very sick and has

Hashimoto's. She won't even consider the implants might have hurt

her health. Hopefully after reading this site she will think about

it.

> Hey, I'm sure you will be fine. I did not have drains either, I

guess I wish in hindsight that my doctor had used them--I wonder

sometimes if that is why it took me so long to heal if I had

bacteria in my body. I know I had an infection because I had

capsular contracture as well as feverish breasts, and Dr. Blais said

my implants were contaminated with mycoplasma. At any rate, I did

heal Lena, it just took me 3 years to start feeling really good

again! I do have Hashimoto's now, and I wasn't diagnosed with that

until last year...nna has said that she heard it was related to

some kind of bacterial infection or maybe viral, not sure, but she

has it too and hopefully hers is going into remission.

>

> At any rate, I just wanted to say that you can heal even tho you

didn't have drains. Don't worry about it too much.

> Patty

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Actually, out of all the illnesses I could be stuck with because of implants, having Hashimoto's is probably the one I prefer! (Not that I want to have an illness at all, of course. I'd love to have my health back fully.) I live a very normal life, though, and hardly even know I have an illness. All I have to do it pop a thyroid pill each night, and for the most part, I don't feel that bad. I think I may have gotten a flare recently with the dental cleaning, and sometimes at night I feel very tired. But otherwise, I have pretty good stamina and can get out and get some pretty good exercise--we work hard at our recreation! I am hoping to go kayaking this weekend on the Colorado River.

I am really sorry about your mom...is she on our group? Maybe she has more than Hashimoto's...nobody ever seems to be able to figure out what is going on with all of us. I really hope that she will be able to put two and two together regarding her implants and her health....how sad for her, and sad for you. I'm hoping your recovery will convince her!

Hugs,

Patty

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

From: lena_beck2004

Sent: Thursday, July 10, 2003 8:12 AM

Subject: Re: Insurance company

Patty,I'm sorry to hear that you have Hashimoto's. I know that that is a terrible illness. My mom has had implants for about 30 years, first the silicone and now the saline. She is very sick and has Hashimoto's. She won't even consider the implants might have hurt her health. Hopefully after reading this site she will think about it.

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Guest guest

Patty,

You have such a great attitude about your health- I hope I get to

that point too. Are there any things that you found to be especially

helpful with your detoxing?

I've been talking to my mom and hopefully she'll come around. I've

sent her a lot of information and she just said today that maybe it

has caused her health problems. She's worried about expense right

now,but I will keep encouraging her. Two of my sisters also have

them and are now talking about removal.

Your kayaking trip sounds fun- I'm from Colorado. I look forward to

being able to hike again and other stuff I'd quit doing. I'm so

happy those things are gone. :)

Hugs,

Lena

> Actually, out of all the illnesses I could be stuck with because

of implants, having Hashimoto's is probably the one I prefer! (Not

that I want to have an illness at all, of course. I'd love to have

my health back fully.) I live a very normal life, though, and

hardly even know I have an illness. All I have to do it pop a

thyroid pill each night, and for the most part, I don't feel that

bad. I think I may have gotten a flare recently with the dental

cleaning, and sometimes at night I feel very tired. But otherwise, I

have pretty good stamina and can get out and get some pretty good

exercise--we work hard at our recreation! I am hoping to go

kayaking this weekend on the Colorado River.

>

> I am really sorry about your mom...is she on our group? Maybe she

has more than Hashimoto's...nobody ever seems to be able to figure

out what is going on with all of us. I really hope that she will be

able to put two and two together regarding her implants and her

health....how sad for her, and sad for you. I'm hoping your

recovery will convince her!

> Hugs,

> Patty

> ----- Original Message -----

> From: lena_beck2004

>

> Sent: Thursday, July 10, 2003 8:12 AM

> Subject: Re: Insurance company

>

>

> Patty,

> I'm sorry to hear that you have Hashimoto's. I know that that is

a

> terrible illness. My mom has had implants for about 30 years,

first

> the silicone and now the saline. She is very sick and has

> Hashimoto's. She won't even consider the implants might have

hurt

> her health. Hopefully after reading this site she will think

about

> it.

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Guest guest

,

Not sure my other message came up, so here it is again in case. My

health insurance is Pacificare HMO. All it took from them was a

letter from my rheumatologist stating that I have an auto-immune

illness that he thinks might be helped by removal of the implants.

In the long run insurance will have to pay more if you continue to

get sicker from implants,so it's in their best interest really.

-- In , " "

<julieyourrealtor@c...> wrote:

> Who is your insurance company? I have fought Blue Cross of Ca for

the last 6 months, my doctor originally tried to refer me out and

they said no because it was not effecting my everyday life. I then

wrote back about my symptoms and some doctors and nurses reviewed

the case and again agreed that since I did not have any hardening

and all my other symptoms were not from implants. I can have a

private party review the case and have the review still, I can send

in now that I have paid for my explant. I am not sure if they will

pay for it..... my symptoms have not gone away yet, it has only been

9 days and I figure it will take some time. Does anyone have any

suggestions as far as what I can write to this private review board

before my 6 month is up in Sept.....thank you...

> ----- Original Message -----

> From: lena_beck2004

>

> Sent: Wednesday, July 09, 2003 10:28 PM

> Subject: Insurance company

>

>

> I was surprised that they paid for it. I really think that the

> implant makers should pay for it. I'm kind of worrying about why

she

> didn't put a drain in. Hope that doesn't turn out to be a

mistake!

>

>

>

>

> --- In , " *~Patty~* " <fdp@l...>

wrote:

> > Awesome! Great insurance company!

> > ----- Original Message -----

> > From: lena_beck2004

> >

> > Sent: Wednesday, July 09, 2003 10:14 PM

> > Subject: Re: Hello. I had explant surgery

> yesterday. I am amazed at how good I'm feeling.

> >

> >

> > Patty,

> > Hi. Yes, I'm certain my scar capsules were removed. I saw a

copy

> of

> > the surgery report and the implants are being sent for lab

> testing

> > because my insurance company had to pay for the surgery and

they

> > demanded that the implants be removed en bloc with capsules

> removed.

>

>

>

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Guest guest

I spoke to Dr. Kolb about the insurance thing. She said you won't be able to get them to pay "after" the surgery has already been performed. This might be true, but I'd still go for it if I were you, ........you never know!

D

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

From: *~Patty~*

Sent: Thursday, July 10, 2003 7:49 AM

Subject: Re: Insurance company

You might want to find out some tips from Dr. Kolb. She says she knows how the insurance industry works with breast implant cases, and she always gets it covered. Maybe she can give you some ideas. Mine was covered too, my explanting doc got it covered in 1998, unheard of at that time, but his tactic was to neglect to mention in his letter that my implants were saline, and he also said that I had BAker IV contractures, which the insurance industry views as a potential liability since it obscures detection of cancer.

Patty

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

From:

Sent: Thursday, July 10, 2003 7:44 AM

Subject: Re: Insurance company

Who is your insurance company? I have fought Blue Cross of Ca for the last 6 months, my doctor originally tried to refer me out and they said no because it was not effecting my everyday life. I then wrote back about my symptoms and some doctors and nurses reviewed the case and again agreed that since I did not have any hardening and all my other symptoms were not from implants. I can have a private party review the case and have the review still, I can send in now that I have paid for my explant. I am not sure if they will pay for it..... my symptoms have not gone away yet, it has only been 9 days and I figure it will take some time. Does anyone have any suggestions as far as what I can write to this private review board before my 6 month is up in Sept.....thank you...

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  • 2 years later...
Guest guest

Hey, I was active early but have not forgotten y'all and still read

the postings. Just way busier than a mere mortal should have to be.

General update is I am still using Xolair (going on three years) and

still doing great.

My job has me travelling quite a bit. Most of the time I forget to

bring the Albuterol. No problem. I hardly ever use it any more

anyway, unless the pollen is high or just prior to exercise.

I was in Washington DC this past weekend. Everything was in full

bloom. Had some sinus congestion, but otherwise no problem.

Congratulations to Doug and Addy for maintaining such a successful

group. It is great to see how much the activity has increased since

the 'early days'.

Good luck to everyone.

Greg

>

> Greg, who was active in the group really early, wrote an

instructional

> piece on working with your insurance company to get covered. He's

the

> HR guy for his company who negotiates their health insurance. I

> turned it into a word document that can be found in the " files "

> section on the left. All group users should feel free to use it and

> pass it on.

>

> Addy

>

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Guest guest

Greg!!! Great to hear from you! Glad you are doing so well on

Xolair! How are the kids?????

Addy

> >

> > Greg, who was active in the group really early, wrote an

> instructional

> > piece on working with your insurance company to get covered.

He's

> the

> > HR guy for his company who negotiates their health insurance. I

> > turned it into a word document that can be found in the " files "

> > section on the left. All group users should feel free to use it

and

> > pass it on.

> >

> > Addy

> >

>

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Guest guest

The boys are doing great. Owen is 7 1/2 and Riley is 18 months.

The activity level in our house is wide open all the time.

Greg

> > >

> > > Greg, who was active in the group really early, wrote an

> > instructional

> > > piece on working with your insurance company to get covered.

> He's

> > the

> > > HR guy for his company who negotiates their health insurance.

I

> > > turned it into a word document that can be found in

the " files "

> > > section on the left. All group users should feel free to use

it

> and

> > > pass it on.

> > >

> > > Addy

> > >

> >

>

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  • 2 years later...

Our insurance company also denied the band. What information did you

send them?

>

> After tearing up the internet searching for articles on plagiocephaly

> and using a couple of letters off of this site for help, I wrote my

> appeal letter to the insurance company. Today, I found out that my

> denial was overturned and they are going to pay for my sons helmet.

> What a blessing since I might be losing my job in a couple of weeks.

>

> I can't thank everyone enough for posting info. My letter wouldn't

> of been the same with out it.

>

> Thanks again,

>

>

>

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I have started gathering information to launch my appeal to our

insurance company too. Any information/advice you can provide would be

greatly appreciated.

Congratulations on your success. The more people who appeal, the more

likely insurance companies will include this treatment in their plans.

Thanks,

>

> After tearing up the internet searching for articles on plagiocephaly

> and using a couple of letters off of this site for help, I wrote my

> appeal letter to the insurance company. Today, I found out that my

> denial was overturned and they are going to pay for my sons helmet.

> What a blessing since I might be losing my job in a couple of weeks.

>

> I can't thank everyone enough for posting info. My letter wouldn't

> of been the same with out it.

>

> Thanks again,

>

>

>

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