Insurance coverage?

Okay I'm a bit nervous. My 1st doctor visit with 1st steroid treatments was May 2nd. Just got a letter in the mail from my insurance company (Unicare) stating that they have requested more information from the doctor's office in order to determine if the visit will be covered. I called and made sure the doctor's office is sending the info and they are. Called the insurance company to see if I could get a better idea of what to expect...because my next appointment is this Friday. And they said they would have to wait to determine until receiving the info...that it could be considered "cosmetic" and in that case, would not be covered. Argh! I don't want to go for another round of injections without knowing whether or not the insurance will cover it. Has anyone else run into this issue? Do you think it will be ok and they'll end up covering it? Stupid insurance!

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Permalink Reply by Trina on May 21, 2008 at 1:02pm
Mandy,

I had this problem. You are going to have to fight them on this. They came to me with the cosmetic issue and letters had to be written, but they did end up covering it. It is not a cosmetic procedure it is a medical condition and insurances can be tricky. Don't back down on this one. Also, How the dr writes it up can also be a determining factor in treatment. Hope this helps.
Permalink Reply by Mandy on May 21, 2008 at 2:29pm
Thanks Trina. Definitely helps. I will fight it then, if they tell me they won't cover it!
Permalink Reply by Heather on May 21, 2008 at 3:30pm
I haven't ran into that exact issue...right now me and my family are going through the insurance to try to see if they cover my custom wig that is going to be around $2300 we've even used the 'medical term' full cranial prostesis and they still say no so we're making an insurance claim and trying to do adocate to our congressman to pass a bill that will require insurance companies to cover the prostesis. But maybe you can try something like that, but if our insurace doesn't cover it we are defintily going to fight it...And i'm the same w/you girl! "Stupid insurance"!!!

<33 Heather
Permalink Reply by Trina on May 21, 2008 at 9:31pm
Heather,

I am not sure if you read the Naaf newsletter but it talks about a bill to cover a wig. If you forward me your email address I can send the email to you
Permalink Reply by Heather on May 21, 2008 at 10:02pm
haha yes thanks..thats exactly what we're doing i'm pretty sure..the bill is like HR something...right??? thanks though!

<33 Heather
Permalink Reply by Char on May 27, 2008 at 9:33am
Every insurance company is different. I would wait for a pre determination before you went in for your next visit. You can always reschedule until you know for sure.

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