We could take the insert back to the medical supply company to be adjusted. We'd have to make an appointment for that in Bemidji. If it gets worse, that's what we'll have to do.
One major problem, is that her inserts are not covered by our insurance. I am completely through the appeals process, and the $668 for each set of inserts as she grows is entirely our responsibility. They would cover AFOs or other more bulky braces, but won't cover inserts as they are deemed "elective". I argued that hers are a documented treatment for issues caused by spina bifida, and not for chiropractic use or back pain as the policy excluded, but was turned down. Who would have thought that more minimal medical devices would be uncovered, but if she had more severe sb, her braces (thousands of dollars) would be paid for in full?!
It seems the consequences of not having the inserts would cost them more money in the long run, were we not to pay for them out of pocket--PT, issues due to walking misaligned that will happen in other parts of her body including joints, etc--but that's just me. It is our goal to have her be able to walk as normally as possible as an adult--at whatever cost.
Wondering if they'd be covered by Obama's health plan??? Hmmmmmm. Probably, but she'd be 60 by the time she received them.
(BTW, liberal friends, before you jump on me, I'm not happy with the current insurance system either. I'm for paying the doctors what things actually cost- not inflated "insurance" costs- and just having large item emergency insurance policies in case someone gets cancer, is in an accident, etc. Day to day things should just be paid for at a reasonable rate. So don't get on me about my socialized medicine comment.)
4 comments:
Hi Amy,
"So don't get on me about my socialized medicine comment."
Hmm, I was just going to augment it. Perhaps I should defer...
Bummer about things not being paid for. I agree that your logic seems better. But then again, HMOs sounded great for encouraging people to keep up with little things in order to avoid the bigger things. Then everyone started using them for free health care.
I certainly agree with you on a solution. We've had high deductible insurance for several years, with a health savings account. Now the cost of our premiums has suddenly jumped enough (almost doubled) that we have nothing left to put in the health savings account. So I don't know the answer either. Think there is perhaps some pressure to increase premium amounts enough that we all come crying to Big Brother?
My other theory, that insurance companies are hoping to be forced out more slowly if they increase the premiums now. Since according to page 16 of the proposed program, anyone needing any change in policy would have to switch to the gov't plan, leaving fewer contributing insurees. So maybe i should be thankful for the rate hike.
Oops, I guess I got carried away. Again.
Mary
Not sure what to do about that either. It would be much cheaper for the government to give each person x amount of money to spend on an insurance policy and medical expenses each year. If there was money left over at the end of the year, the money could be pocketed- hopefully encouraging people to avoid needless medical spending. That would eradicate the whole welfare system and be equitable to all, not to mention save millions of dollars each year. But. . . who am I to suggest political changes? ;)
Sorry you're having so much trouble. Dealing with insurance can be so frustrating. So how often will you have to replace them, every time he shoe size changes? Just try and think about the return on investment you'll get from her as her walking improves!
Brooke, what you described is pretty much the essence of having a health savings plan. Those are probably the wave of the future (Dave Ramsey recommends them). You put money into an account (I believe pre-tax) and you can either spend the money on your healthcare or keep saving it. You can put it into the stock market to try to grow it. They offer this where I work, in conjunction with a high deductible health insurance plan. The theory is that once you've paid up to the $2000 deductible (out of your account), insurance will pay 80% of everything else. But you have to build up that $2000 to begin with, and if you have a lot of health issues in your family, chances are you will be starting from scratch every year. But if things go well, you can build that account year after year, and in theory end up with a huge healthcare nest egg.
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