No Surgery
Isaac has been denied again for a second cochlear implant. We will not have surgery on April 7th. Apparently, Amerihealth Mercy says that Isaac has made too much progress with the first implant to justify the cost of a second one. We are working with the Let Them Hear Foundation. I am pretty sad about the whole thing. Maybe if we had a different insurance provider this wouldn't be happening. I have definately shed more tears over this than I ever thought I would. Unfortunately for us, we are the first ones confronting our insurance companies with this request and are willing to appeal their decision. I know that God is in our corner. I know that His Will will be done, but sometimes it is hard to find the comfort in it all.
posted by Shiloh @ 9:37 AM
9 Comments:
Shiloh, I am so frustrated and sad for you! Wish they could see how much BETTER he'd do with two! I hate that you'll have to postpone the surgery and appeal this all...but I agree...it's all in His time. Hopefully it will all happen soon...the sooner, the better, I think! ((hugs))
Shiloh, this is such sad news. I'm sorry. :( I know there isn't much I can say right now to make you feel better, but know that Isaac *is* doing so well.
He is an extraordinary boy who has already blown us all away with what he can do.
If it takes another few months or even years for him to get his second implant, he will do just as well as kids who get both at once - if not better. (This *is* Isaac we're talking about here!)
Don't lose hope. This will happen. Hugs.
I'm so sorry Shiloh. I have to agree with Wendy, Isaac is an incredible little guy who is making the best of his situation and he'll continue to thrive no matter how long the wait. Hang in there, sending prayers and hugs.
I'm sorry to read this Shiloh. I am impressed by your strength through this and hope all works out for you. Isaac is a bright, happy, engaging child who - one implant or 2 - will do great! That being said, I hope the LTH foundation can help you work through this.
Insurance issues are so difficult b/c it feels like so much is out of your control.
Hang in there.
Jennifer
I lived your frustration. I was denied my bilateral implants as well. Let Them Hear is a fantastic organization. Sheri will do her best. It did take a year to get mine resolved. Good news is I had my surgery on July 19, 2007 and I have my bilateral implants and loving each second.
Valerie
Did you contact OMS ?http://www.omsinsurancesupport.org/ they should be able to help you no matter what brand of implant you choose. My son has one and does super well w/it but he's unilateral only because of malformations in his ear not because of ins denial. My daughter wears two. Keep pushing, you'll get it approved w/the right help.
Valerie,
Let Them Hear is wonderful. We are hoping that it won't take a year to get his 2nd implant approved, but we will fight until we win.
Val,
We thought about contacting OMS, but the personal attention and track record that The Let Them Hear Foundation has makes us more comfortable with them. OMS is fairly new. This is too important an issue for us to go with OMS before we see proof that they are as successful as The Let Them Hear Foundation. Your kids are too cute. I visit your blog often.
You will win this battle for your son, because you're his mom, and I know you won't accept 'No' as the final answer. Go to the media if you have to, the newspapers in your region, anything that will make the insurance co. do the right thing. Good luck to you and your beautiful son.
Shiloh,
I saw on CI Circle yesterday where CHoP is no longer doing bilaterals. Will this affect Isaac, or will he be "grandfathered" in, once you win your insurance battle? I immediately thought of you when I saw the posting.
I am shocked that a hospital with such a wonderful reputation has taken this position. I see the medical necessity of bilateral implants on a daily basis with Drew. I can't belive that a program would take this stance. Many on the circle felt it was an issue of $$. Whatever it is, it is wrong, and I hope they see the errors of their ways soon.
Please keep us updated on Isaac and your progress. We're here to help!
Drew's Mom
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