The sleep neurologist's office called to let me know that the CPap information had been sent to the Home Healthcare Company (HHC). I gave the HHC a call to determine what we needed to do next (if anything): apparently, we just have to sit tight and see if our insurance company will pay for a CPap machine. The insurance company will likely require an authorization, then they'll decide if they will chip in for the machine or not. You know, because breathing is totally a "lifestyle choice."*
Like hearing aids (and many other "durable medical equipment"), CPap machines are often not covered. Fortunately, we'll "only" be out about $1,000 if our insurance company refuses to pay for the machine. We'll see what happens.
In the meantime, Nolan is sporting his first ear infection since getting T-Tubes. He brought me a clogged hearing aid and a leaky ear: it isn't pretty, folks. He has gone nearly 8 months without an infection, which is pretty record-setting in our world. Hopefully a round of Ciprodex drops will clear this one up (oh, the joys)!
*Hearing aids are often not covered because wearing them is considered a "lifestyle choice" among adults. Unfortunately, children learning to listen and speak are adversely affected by the refusal of insurance companies to cover hearing instruments.
5 comments:
A lifestyle choice?!! I wonder if that is taking political correctness a tad too far? You would think that the insurance companies could differentiate between adults who choose to wear or not wear hearing aids, and children whose parents need to make that life directing decision for them. Very strange.
I hope your insurance comes through for you! We purchased a nebulizing machine for X at the cost of $140, a very small price to pay for avoiding trips to the ER every couple of months. Our ER is entirely free (unless you call an ambulance, which costs $45), but why go if you don't have to?!!
Oh that is just INFURIATING.
That insurance companies put hearing aids and CPAP on par with elective things (like a boob job)... makes ya want to go postal sometimes.
There's just no logic.
Hang in there,
Julie
Some days you just wonder how insurance controls the life.......these lil beautiful kids have to be worked on and your mind is never free of what is covered and what isn't.I wish life was simpler some days.I wish insurance companies could realize how somethings are absolutely essential.
They cover Viagra, of course. Because some things are just more important than hearing or breathing. Well, I hope you win yet another insurance battle.
The only good news (I suppose) is that a CPap machine costs less than hearing aids - the entire set-up will cost us about $1,000. Of course, Nolan will need three different masks to rotate through because he has midface hypoplasia (that gives him the flat nasal bridge), so that will up the $$ a bit.
We have a friend who has a little boy who wears two prosthetic legs: insurance doesn't cover prostheses, either. Fortunately, Shriner's donates these free of charge (these are also more expensive for children, because kids require new legs every time they grow).
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