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So pissed and need to vent!

Posted by on Apr. 30, 2012 at 11:00 AM
  • 25 Replies

My son was diagnosed with plagiocephaly over a month ago. Its basically a prominent flat spot in the back of his head. I was told that he would need a cranial remolding helmet. Well for over a month now I was waiting for the approval from Tricare so that way we can get his head scanned and the helmet ordered. With plagiocephaly time is of the essence as the babies sutures begin to fuse together and the head is not as pliable and the longer we wait the less results we'll see. I had mentioned the flat spot to his doctor when he was three months old and they said, "Oh it'll round out when he starts rolling over." I began supervising him with side sleeping and more belly time... which he absolutely hated and would scream bloody murder. He would automatically roll onto his back or try to fix his head so he was laying flat on it. I bought a wedge to try to keep him in place.. I bought fitted hats, I bought a remolding pillow... but the flat spot has just been getting worse. I just found out that Tricare has denied the claim for the helmet because they will only pay for it if he has had cranial surgery to open his sutures. Are you kidding me?!? Why can't we get the helmet before it gets to that point??????

  I spoke to the company that handles the treatment of plagiocephaly and asked how it will work if we pay out of pocket. He said he gets 3550 from the insurance companies, but he knocks off 550 for those who pay out of pocket. OK 3 g's... I can work with that. So I then asked him how does out of pocket work, can we do a payment plan of 400 a month? He said NO!  That because the helmet is made tailored to my child's measurements , once he orders it he can not use it for another child and he can not return it. He said that he has to cover the cost of the helmet so we have to pay half up front. I completely understand his logic but seriously 1500 dollars????  My husband and I were in a very bad financial state not that long ago, where we had to use up all of our savings. We just got out of living paycheck to paycheck and are able to start saving some money.. but I don't have enough saved up. UGH why can't they do payment plans?!!?!? I can shell out 400-500 a month for the helmet but he said no he wants half now.. and half in three months. So here I am on the Internet looking up other companies in the area to see if any of them will work out a payment plan for those that pay out of pocket... or maybe if there is a charity organization that will be willing to work with us. Even saving up the money I wouldn't be able to get his helmet until he's 9-11 months old (he's six months right now) and by that time he will need additional scans to ensure his sutures haven't fused together. UGH i hate insurance companies!!


I am literally at a lose for words with the amazing pms Ive been getting! Thank you all so much!! I am literally in tears that so many women are willing to try to help my son. I have emailed two organizations that help with the cost of the helmet.. FINGERS CROSSED.. but I truly and utterly mean this from the bottom of my heart.. thank you all for the help!! You have found things I did not find in my search and I am literally amazed that there are strangers out there that are helping my son! Thank you... 

by on Apr. 30, 2012 at 11:00 AM
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Replies (1-10):
lucky2Beeme
by Platinum Member on Apr. 30, 2012 at 11:05 AM

  hugs momma I am sorry. Seems like your insurance should have picked this up to me. I am sorry they are not.

Cookie-kisses
by Platinum Member on Apr. 30, 2012 at 11:10 AM

 That sucks. ;o(  Check around there more than likely is an organization like you mentioned. I was gifted a 25k piece of medical equipt. from an organization of my illness.

marinenonstop
by on Apr. 30, 2012 at 11:11 AM

thank you, my husband and myself truly believed they would. It says they do coer 80 percent of cranial remolding helmet, but not for plagiocephaly. They said until he has the surgery to open his sutures it's considered cosmetic.

Quoting lucky2Beeme:

  hugs momma I am sorry. Seems like your insurance should have picked this up to me. I am sorry they are not.


marinenonstop
by on Apr. 30, 2012 at 11:13 AM

so far the only charity that helps with plagiocephaly i have found is in london. :(

Quoting Cookie-kisses:

 That sucks. ;o(  Check around there more than likely is an organization like you mentioned. I was gifted a 25k piece of medical equipt. from an organization of my illness.


metalhealthmom
by on Apr. 30, 2012 at 11:13 AM
I can't believe they wont cover it and would require surgery first. That's so shitty. And I hate when companies that provide medical equipment wont work out payment plans.
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northernmommy
by Jen on Apr. 30, 2012 at 11:14 AM
2 moms liked this

 can you take out a small loan to cover the cost of getting the helmet? if you were willing to make payments to the Dr you should be able to do it with a loan. DH took out a $3000 loan a while back and the payments were less than $200 a month.

wiggles653
by on Apr. 30, 2012 at 11:18 AM
My son had same issue we waited. Till 9 month growth spurt it lookks a lot better no helmet needed
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marinenonstop
by on Apr. 30, 2012 at 11:20 AM

honestly, I have no idea why we have been denied for a loan. My husband took out a 5000 loan about four years ago, the min monthly payment was 175 and we always sent 250+ every month and never missed. We have taken out two car loans and have never missed a payment. We rent our apartment and have never even had a late payment, however when I spoke to the bank about a personal loan for medical equipment we were denied for lack of credit history. I could not understand how that is the case when we have credit cards, we've never maxed them out and we always pay on time, we've had two car loans, we've taken out a personal loan.. everything was always paid on time and more than the minimum payment due I can't understand it.

Quoting northernmommy:

 can you take out a small loan to cover the cost of getting the helmet? if you were willing to make payments to the Dr you should be able to do it with a loan. DH took out a $3000 loan a while back and the payments were less than $200 a month.


marinenonstop
by on Apr. 30, 2012 at 11:22 AM

I'm glad it worked out for you but my son has moderate plagiocephaly. It was severe but we tried our best keeping him off the back of his head as much as possible. The supervised side sleeping helped out.. but he still has a moderate case that will not self correct.

Quoting wiggles653:

My son had same issue we waited. Till 9 month growth spurt it lookks a lot better no helmet needed


marinenonstop
by on Apr. 30, 2012 at 11:26 AM

S far it looks like companies starband and hanger are the way to go to see if I can work something out with them.... fingers crossed as I will be calling them later after I get out of class.

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