Denied Completely
Today was a bummer of a day. Ian's private insurance will cover Isaac's second implant 80%, but we received a letter from our state's medical assistance insurer (Gateway Health Plan) that they will not cover a second implant because, "After physician review, the request for service is: denied completely because: the second cochlear implant is denied as because it is determined to be experimental and therefore not a covered benefit of the Pennsylvania Medical Assistance Program or the Gateway Health plan."
I am so angry and sad. I don't understand why we have to fight for so much. I try to stay positive most of the time, but this has really hit a nerve for me. We struggled so much with the decision and now it seems like we are being slapped in the face. I know I have to write letters and make phone calls, but I am just so tired. Tired of insurance companies controlling everything! I kind of expected a denial, but I was hoping for the best. I am going to contact CHOP and the Let Them Hear Foundation tomorrow. Please say prayers for us. Hopefully tomorrow will be a better day.
5 Comments:
Oh, Shiloh, I'm sorry :( How discouraging! They will likely come around eventually, but I know you're discouraged...this shouldn't be so hard, should it? (((HUGS))) Hang in there!
Oh no!! I'm so sorry. I hate the fighting and frustration that comes with the territory. *hugs* hang in there. I hope you can find some help fast.
Oh, Shiloh, that is just awful news.
Let Them Hear does amazing things, and I am confident they will be able to help you.
But it is still so discouraging to have to fight for what is right.
Please keep us posted on how things are going.
Big hugs!!!
Wendy
Hi Shiloh,
My name is Amy Brown. I am the Associate Director of the Let Them Hear Foundation Insurance Advocacy Program. You can reach me at (650) 617-2255. I welcome a phone call from you to discuss your son's bilateral cochlear implant appeal.
Best regards,
Amy
So sorry to see this post Shiloh. I know how you are feeling, we have lost our state assistance recently and it pays for massive amounts of therapies that our insurance denies. It's very disheartening.
On the bright side, you've got some very smart people at LTHF and parents on CiCircle who can help, and you are very intelligent and willing to pursue it. It will be done.
Happy Holidays to you and your beautiful family.
xoxo
Heather
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