InfantReflux.Org Forums: Changing insurance and worried

Message

   My dh is changing jobs and unfortunately he will have a new insurance company.  Currently we have United Health Care and I love it!   With all of the testing we've had to have done with Noah,  they have covered all of it,  including 40 OT and 40 SLP visits per year.   His new insurance is Anthem and they only allow 20 SLP and 20 OT visits per year.   Noah is supposed to go every other week to OT for feeding therapy and with only 20 visits per year,  we'll run out with 3 months left in the year.   I was told that I can appeal and try to get more visits,  but I'm sure that is unlikely to happen.  Does anyone else have Anthem and have had to appeal? 

Edited by lisaann - 21 March 2006 at 4:42pm

Author	Message
lisaann Fan Joined: 21 October 2005 Location: United States Online Status: Offline Posts: 318	Topic: Changing insurance and worried Posted: 21 March 2006 at 4:41pm
	My dh is changing jobs and unfortunately he will have a new insurance company. Currently we have United Health Care and I love it! With all of the testing we've had to have done with Noah, they have covered all of it, including 40 OT and 40 SLP visits per year. His new insurance is Anthem and they only allow 20 SLP and 20 OT visits per year. Noah is supposed to go every other week to OT for feeding therapy and with only 20 visits per year, we'll run out with 3 months left in the year. I was told that I can appeal and try to get more visits, but I'm sure that is unlikely to happen. Does anyone else have Anthem and have had to appeal? Edited by lisaann - 21 March 2006 at 4:42pm
	Lisa - mommy to Alec 7/96, Connor 3/99 my preemie, and Noah 4/05, periactin, mashed and table foods and lack of interest in eating.

	IP Logged

Sharon Liu Fan Joined: 09 September 2005 Location: United States Online Status: Offline Posts: 285	Posted: 22 March 2006 at 4:32pm
	Lisa: You can ask your son's ped contact the insurance company to get approval in order to get more visits per year, that is what my son's ped and insurance company told me. You can also get OT and ST from EI for free depend on your family income.
	Sharon, Fred Brian 1/14/2005 GERD, Urinary reflux, Prevacid, Furadantin,
	IP Logged

pkkb Senior Member Joined: 17 August 2004 Location: United States Online Status: Offline Posts: 3200	Posted: 22 March 2006 at 7:35pm
	I have Anthem. We've never done ST or PT, so I can't speak to that. We've had to appeal 3 things. Two were approved easily. The third (Nutramigen) was rejected. At the time, we were so tired from dealing with Kaelyn that we chose not to fight it, so I don't know what would have happened in the end.
	Kim Kaelyn 6-04 reflux- Off prevacid -- Outgrew Allergies to wheat, milk, peaches, and apples Alexandra 6-06 - 36 weeks, reflux, laryngomalacia, asthma, no allergies!!
	IP Logged

hellbennt Admin Group Joined: 28 August 2003 Location: United States Online Status: Offline Posts: 13402	Posted: 22 March 2006 at 8:07pm
	I was going to mention trying EI (sometimes called the 0-3 program) and appealing insurance as well- I dont have the link handy, but if you search 'going to the top' you'll find it
	~laura~ Jonah 7/03:GERDfree@12mos! Silent Reflux@birth(apnea episodes/NICU);Past Sandifer Symptoms, breastfed->15mos Ari 7/06 REFLUX FREE, so miracles do happen!
	IP Logged

Insurance Issues
InfantReflux.Org Forums : Non-Reflux Information : Insurance Issues