My Insurance Will Not Pay

[abirk]

Hi Everyone,


We found out last week that our insurance will not pay for laser on my daughter's H. The letter they sent us said the plan excludes cosmetic or reconstructive surgery. I was ready to argue about the cosmetic part but I don't know how to appeal the reconstructive part because it really is reconstructive. Does anybody have any tips on how to write an appeal to the insurance company?

ps. It is a small, superfical H on her nose.

[EJsMommy]

Depending on how it looks, may influence their decision. I, myself am in the process of applying for coverage as well. My daughter's H is very large and on her forehead.

Anyways, I included the "CARES ACT" as well as "Children with Deformities" act. They are not officially passed, but they are acts that have been introduced and being evaluated (Correct me if I'm wrong).

Try and be persistent, that's what I'm doing. But, argue that perhaps it is to restore a normal appearance.

Insurance companies are brutal at times, it's heartbreaking. I wish you the best of luck and keep us updated!

[missy]

We have an expert for that:

http://birthmark.org/experts.php

She might be able to help you.

Missy

[abirk]

Thanks to all who replied. We are going ahead with the laser. Our doctor reduce the cost and we are having to pay $500 for the procedure. Not to bad. They think it will only take 1-3 laser treatments. We are still going to appeal any how.