Insurance

I have been grateful that we have medical insurance through all we have been through with our Macie, they covered a huge portion of her $35,000.00 hospital stay. We have met all our deductibles and out of pocket portions so I thought, this helmet would be for the most part covered. Especially since when I called to get it pre-approved they seemed so optimistic. Well when we went to pick up the helmet the orthotics place told us that the insurance denied the claim. I expected this would happen but I wasn't prepared for the reason why and it made me so mad. They decided that they would only cover this as a postoperative procedure. That means she would have to go through the cranial surgery where they break the sutures (where the cranial bones fused together) open and reposition them. Then she would wear the helmet to help reform the head and protect it from further injury during the healing process. The main reason we decided to get this helmet is so we could avoid all surgeries. We have been through enough with hospitals. It made me mad that they were willing to cover this extensive surgery plus the helmet, but won't cover the helmet so we could avoid having future issues with her sight, hearing, jaw, etc that can be caused by the flattening pushing forward her facial features. I am going to appeal this but had to get how irritated this made me off my chest. I am not giving up easy on this. So even though insurance is great to have and so expensive some times it is irritating!