Okay, bad news first. Today was Judson's ocularist appointment to get another conformer. BTW, They are getting so big and hard to get in but Judson handles them so well. Today I found out that BC/BS will not pay for the conformers nor the scleral shell. That's a whole lot of change $$$. Because of Judson's problem he is also on Medicaid but...Medicaid will not pay either. So pray for me as I start battling the insurance company through appeals to try and get them to pay something. It really doesn't make since to me. Why would they not cover the cost to give my baby a chance to have a normal looking appearance? I mean this isn't like I am having his teeth whitened or something. If they will pay for a prosthetic leg or breast than why not an eye? Anyhow, that's the bad news.
Now, the good. Judson has been tolerating the larger conformers so well that he will be able to get his painted scleral shell January 26th! YIPPEE. I was told that he would be in conformers until he was a 1 or 2. He will be 9 months old and already have his. I don't know really what to expect. The next appointment will take half the day while they get a mold made from the conformers and hand paint it, clear coat it, shine it up and put it in. I know that they will not get to do a mold of his good eye until he is 4 so this first shell may not be the "perfect" fit that later ones will be. I also found out that the normal length to keep one shell before needing a new one is 7 years. We will need to have it cleaned and adjusted twice a year. Of course, all this would not be covered under insurance and totally out of pocket unless God intervenes. But today I am just thanking the Lord and kissing all over my baby boy for being able to handle these irritating conformers so well. Tomorrow I will ruffle my feathers and get down to business with the big wigs.
4 comments:
well, all that really didn't make sense to me because i don't really understand the disorder or the treatment, but the insurance thing does make sense and i feel for you. it really is irritating to have to deal with situations like this. but i know you will be persistent. most of all, i know God will provide for His children's needs. what a blessing that Judson is ahead of schedule with his treatment. i guess you have considered a patch before, but just in case you hadn't, i thought i would mention it. i am sure he's going to be a good looking boy and a patch might even make him sexier in his adult years! (oooohhh gasp....i can't believe she said that, you should read what Linda Agee wrote, i don't think that is very appropriate-lol-i'll just go ahead and say that for everybody who gets their hair up haha)
keep us posted and i'll say a prayer that it all gets taken care of expediently.
xxxooo
We have thought of a patch but we do not know yet if he has light perception (sp?). Prob. not but if so, then a patch would hinder that. Thanks for your prayers. I bet you have had your rounds with insurance companies/ Medicaid.
This may sound weird but I am going to miss his small eye! Hey, on ER most of there insurance problems work out... so I'm sure thay will for you to!lol
oops, I mean "their"...go homeschool!
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