Oh My Gosh I cant do this anymore

iVillage Member
Registered: 05-02-2003
Oh My Gosh I cant do this anymore
6
Thu, 02-10-2005 - 5:24pm
My Insurance company has decied to not pay for OT because they say that all of Christopehrs Dx are menatl health and not medical.I was told that they where medical and not mental.Oh CRAP&^%^*^%*&^&( I can do this anymore.How can I get him the help he needs when I can pay for it.Now we have another huge bill to pay.We have so many medical bill for my little man.Surgeries,prosegers,meds,equipment.Oh I am losseing it OH Gosh.I cant stop crying.Gotta go Tammy
iVillage Member
Registered: 01-15-2005
Thu, 02-10-2005 - 7:54pm
I know insurance sucks ...Please hang in there. There has to be something out there to help you..Can your doctor write your insurance and tell them its important that its covered.. Hugs
iVillage Member
Registered: 11-01-2004
Thu, 02-10-2005 - 9:30pm

Tammy Kim was talking in another post about a service that can help families pay for this stuff (OT, SP etc).

               

 

iVillage Member
Registered: 09-20-2004
Fri, 02-11-2005 - 2:48pm

Tammy,

Gabriel is on an insurance called the LOOPHOLE program. What happens is it goes through my husbands insuracne first (primary)and then the loophole will cover the rest (secondary insurance). You could be a millionaire and qualify. All you have to do is show proof of you childs disabilities (evaluation reports, surgery paperwork and etc.). When Gabriel qualified his only diagnosis was developmentally delayed (st, ot, pt) and his eye surgeries. I'm sure you would qualify.

I've read posts on the Dev. Delay board and MANY other children in other states are on similar programs. Call the special needs network. It is so worth it to get your child insurance that will cover his services.

If he qualifies tehy will also back date three or so months and pick up your other medical bills. Gabriel's genetic testing was covered....that was a relief!!

If you have any other questions just ask :)

Kim

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iVillage Member
Registered: 05-02-2003
Fri, 02-11-2005 - 4:11pm
Thank you so much Kim.I will call around and see about this.Do you have any idea how to find this program?Should I call my old case worker from first steps and ask her?Again thak you so much.Tammy.
iVillage Member
Registered: 05-02-2003
Fri, 02-11-2005 - 4:14pm
Well we are going to fight the insurance on this one.The Doc. and OT are going to write a letter to the insurance but it may not help much.Ill keep working on this one.Untill we can get the OT back I guess I will try to do more OT stuff here at home.Tammy
iVillage Member
Registered: 09-20-2004
Fri, 02-11-2005 - 11:07pm

Yes, call your case worker. Gabriel's Early Intervention cordinator is who helped us. I was complaining to her about medical insurance and she then mentioned it to us. You can also call the special kids network - they may be able to direct you.

Glad to help :)

Kim

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