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I am not a doctor...Please do not mistake anything you read here (on Autoimmune Island) for medical advice.
Decisions regarding you or your child's health care should be made only with the assistance of your doctor and/or your health care specialists.





Friday, May 7, 2010

Approved!

Since January 31st, we have been trying to get our insurance to cover the cost of a prosthetic hair device (aka "wig") for our nine year old daughter who was diagnosed with Alopeica Universalis in June 2009.  For those who don't know, a customized wig made out of real hair can cost over $1,200.00 dollars. Insurance or no insurance, we bought a wig in January for our daughter and turned the receipt into our insurances.Our daughter had pretty good self-confidence before this happened to her and we as her parents wanted it to stay that way....sooo we borrowed from our savings hoping that my husband's insurance would cover some of it.  My insurance flat out states that they do not cover wigs for any reason.  My husband's insurance stated that it did cover wigs (how much?...it was very unclear), but we kept getting denied with the reason....it is not a medical necessity.  How could they say that?  You stand in front of my daughter and tell her that.  It has been numerous phone calls back and forth, letters from our dermatologist, etc.  Yes, my daughter is healthy otherwise (knock on wood), but her condition, at times, causes significant emotional distress and embarrassment to her and can have an adverse impact in her socialization.  It's her mental/emotional health that we worry about. 

Today,  I came home to find an insurance letter which I thought was going to be another denial, but I found these words instead....

"Based on a review of the faxed clinical information provided, the above request for services has been approved.....Based on the information provided to us, this approval certifies the medical necessity and appropriateness of the proposed care and services....Excellus BlueCross/BlueShield has approved this request for services and will pay for these services according to the terms of your contract."

A BIG SIGH OF RELIEF!

Now on to the next insurance issue....getting coverage for our youngest daughter's insulin pump.....hoping to be pumping soon!

5 comments:

  1. Hooray! That brought tears to my eyes. Anything to make your cute girls' lives easier is a dream! They deal with so much already. Congratulations!

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  2. Congrats!! That is so wonderful...you mean insurance companies actually listen sometimes??? Amazing. They say they'll pay according to the terms of your contract...hope it is a big percentage of it! And good luck on the pump!

    Hooray for a little relief!

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  3. Well, good grief.

    Why do we have to fight so hard for services that our children need?

    I'm so happy to hear they approved it and I'm praying it's a HUGE chunk!

    Let us know how the pumping journey goes :)

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  4. Whoo Hoo! It turns out that my husband's insurance is going to pay 80 percent....awesome!

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