Health Insurance question

[Cowboy]

So we consulted with an endocrinologist today for my daughter. She is below the growth chart so they are mapping her chromosomes to check for genetic abnormalities. They said they will then put her on growth hormones if insurance allows it because some insurance companies refuse all growth hormones and it will cost 1200 a month without insurance. With the hormones she has the chance to be average size without she has a chance to be 4'11" maybe.

Has anyone here had to fight with insurance over something like this? The DR said some just refuse all together and some are just like OK Doc you know what's best.

 

[noway2]

Has anyone here had to fight with insurance over something like this? The DR said some just refuse all together and some are just like OK Doc you know what's best.

I haven't had to fight anything like this. Just some things that require "pre authorization".

What I would suggest as a first step is to see if you can find your benefits book, which is probably available online. It should contain a list of things they'll cover and things they'll categorically deny.

 

[fieldgrade]

what noway said. ^^^

 

[teamglock2002]

I would suggest you call your agent and let him dig into it from his side with the insurance company. He will prob get better response then you would.

 

[cold1]

I suggest getting a 2nd opinion.

 

[Cowboy]

I suggest getting a 2nd opinion.

Won't know what any kind of diagnosis is for 3-4 weeks when the chromosome test comes back, said it might be something called turners syndrome.

 

[Cowboy]

I would suggest you call your agent and let him dig into it from his side with the insurance company. He will prob get better response then you would.

I might have to call and ask my rep about it once we get to that point. The Dr said they work with the drug companies pretty closely if insurance doesn't cover anything.

 

[Carolinatlc]

All three of my kid's and my wife have to go to the Endocrinologist yearly for checkups because of thyroid issues and are all on Synthroid or similar. It was a constant battle to get Dr. visits coded correctly and prescriptions reasonable. Ended up switching to one of the shared medical plans for coverage and an HSA and pay everything out of pocket now. Dr visits cost a little more now but prescriptions have actual gone down because of the specialty pharmacies out there that might only deal in one drug.

 

[cold1]

Won't know what any kind of diagnosis is for 3-4 weeks when the chromosome test comes back, said it might be something called turners syndrome.

Keeping my fingers crossed that its nothing serious for yall.