Military Insurance Says 'No' to Baby Helmets

[sabra]

Source: ABC News

Mothers Turn to Charities to Pay for Helmets to Correct Misshapen Heads

Katherine Regalado, 28, only saw the adorable baby smiles and a new older brother's doting attention to her baby Isaiah this summer. Yet, when Isaiah reached 4 months, her pediatrician noticed a problem she had missed.

Like many babies at birth, Isaiah's skull was misshapen. Only Isaiah's head never returned to a symmetrical shape. Doctors told Regalado, a stay at home mother of two living on Nellis Air Force Base, that the distortion had spread so much that it could soon leave Isaiah with a permanently asymmetrical head.

But Regalado was in for a bigger surprise. Her military insurance, TRICARE, wouldn't cover the orthotic helmet that experts promised would largely correct Isaiah's condition, called plagiocephaly.

"TRICARE paid for all the specialists leading up to the diagnosis until they ordered the treatment and then they (TRICARE) said no," said Regalado.

Regalado, whose husband is currently serving in Iraq, said she couldn't afford the $2,500 for Isaiah's helmet. Saving money over time wasn't an option either, since doctors told her children's skulls only stay malleable for the first year of life. After that, any misshapen bones would be permanent.

...

In a statement sent to ABCNews.com, TRICARE wrote "& the bottom line is that TRICARE cannot, by law, cover this device until there is reliable evidence to show that both of the following are true... 1) Positional plagiocephaly impairs a bodily function AND 2) Cranial helmets are safe and effective."

Read more: http://abcnews.go.com/Health/WellnessNews/baby-helmets-misshapen-heads-covered-military-insurance/story?id=9763312

[midnight]

1. K&R

[KatyaR]

2. I worked for an insurance company once, and we always denied claims

for these helmets. There's one practice in town that prescribes them for every kid who walks in the door, so it's hard to say if they were medically necessary or not. I always felt bad for the parents, because they were always really upset about it.

I think it's common practice to deny these with most insurers. Whether that's right or wrong, I don't know.

[ParkieDem]

4. Personally, I think these helmets are a racket.

I have a 5-month old, and our pediatrician referred us to a place that did free consultations on the issue because the little guy had a slight flat spot on his head.

I asked up front how much it would cost, and they said about $3800 if you don't have insurance. I then read up on the issue, talked to another pediatrician friend, and found out that almost all of the cases of plegiocephaly clear up on their own by the time the child gets to be a year old.

If insurers are denying coverage as a matter of course, that sucks. But what sucks even worse is that there are these helmet companies out there trying to take advantage of insurance and scaring parents at the same time.

[KatyaR]

5. That's pretty much the reasoning we used,

but try telling that to a hysterical parent who thinks their child is going to be permanently impaired or even brain damaged because of it.

[jberryhill]

6. I had it... and didn't get a helmet...

My baby pictures are downright scary. I had a bizarrely shaped head at birth.

As you mention, it went away in a few months.

[ParkieDem]

8. That's the thing about these issues

I'm not 100% sure if these helmets are a "racket," but if such a racket is "exposed," the real people who suffer are those who truly have a problem.

This was true in Texas back when workers comp fraud was big. You had all sorts of people claiming fake injuries to get workers comp benefits, and there was a big backlash ... but that backlash applied to everyone -- including those who really were injured on the job. Instead of sympathy, the truly hurt got skepticism.

[jberryhill]

9. I'm by no means a pediatric physician....

Of that much, I'm certain.

[Mari333]

3. a Helmet might be better then THIS

mother puts Beyonce wig on bald baby to make her look 'more lovely'
http://www.thefrisky.com/post/246-new-disturbing-trend-baby-wigs/

[rocktivity]

7. THIS is what you get a for a bald baby girl if you want her to look more lovely

The Beyonce wig is a joke, of course. Of course. OF COURSE!!!

x(
rocktivity

[jberryhill]

10. Actually, that's the kind of thing that you use...

...when the baby's head is mis-shapen (which is pretty common and grown out of).