Monday, December 27, 2010

Baby's New Accessory

My baby has a new accessory... a helmet.  Yes, I am the proud momma to a "helmet baby". 

Autumn was diagnosed with plagiocephaly - basically a significant asymmetry to the shape of the skull.  A lot of babies have a flat spot, due to SIDS and having to place babies to sleep on their backs to reduce the risk.  But even with the amount of time that Autumn spends sitting up and on her belly, her "flatness" was not getting better - it was getting worse.

So, we had many doctor's visits this fall, took some xrays and saw a plastic surgeon.  Fortunately, the plates her in her head are all open so we didn't have to go the drastic route of surgery, but three physicians all advised me to have her go to an orthotic specialist to get fitted for a custom helmet.  Joel and I talked on the phone and via email a lot about this, but it was really hard to be the only parent here to make the final decision.

The night after we saw the plastic surgeon, I was doing some research on the Internet and saw an article that talked about how Tricare (the military insurance) will not pay for baby helmets.  (You can read that article here.)  I was shocked when I read that article and immediately went to Tricare's website to look up their coverage, and I was surprised to see it in black and white.  They weren't going to cover it.

The next day, we got in to see the orthotic specialist and the owner happened to be the person who saw Autumn.  We did all the measurements and the 3-D scan and I mentioned to him that I was 99% positive that Tricare was going to deny the claim, but that I would look into grant money to pay for it.  He kept telling me not to worry about the money, but to focus on Autumn.  I was stressed because I knew that Joel and I wanted to go ahead with the helmet and treatment, but everything in total cost around $3800.  The helmet itself cost $1800 and then there is about $2000 in visits, treatments and measurements.  We're a military family and $3800 is a major chunk of change for us.

As we left that first appointment with the orthotic specialist, I went to make an appointment for a follow-up visit.  As I was talking with the receptionist, she mentioned that the owner told her that he would accept $1500 for the helmet and all the treatments that are needed for Autumn's care.  I couldn't believe what she said - that's a $300 loss for the cost of the helmet alone and then he would be eating all the cost for the treatment  My mom was waiting with Grace in the car.  I told her what just happened and both of us just sat in the front seat of the car together and wept.  God was taking care of us.

I came home and emailed Joel all the details about the visit and told him I would start looking into grant money that was available through an Indiana non-profit for military families.  Over the next week, I did my research and started to gather the paperwork I would need to submit for the grant, but I was still waiting for Tricare to deny the claim.  They did and it shook me.  I was so mad.  Joel and I don't feel entitled because we're a military family, but believe me, he works hard for what we have.  I was mad because I knew by research I had done, that the baby helmet was very common, was approved by the FDA and so many insurance companies pay for them.  What made even less sense, was that Tricare didn't have any problem paying for the half-dozen doctor's visits and all the xrays that lead up to her diagnosis.  They paid almost as much in all those medical costs as the cost of the helmet.

I shot off any angry email to my congressman ... I'm pretty sure their kid wouldn't go without and they're the ones who decide what military insurance covers...  Anyway, that's a major soapbox issue that I'll just leave be.  I made a random post on Facebook about having to work on the grants, and what came next floored me.

In the four hours after I made my angry Facebook post, six people contacted me.  Each of them said that they would happily pay for Autumn's helmet in full so that we weren't burdened by it.  Six people willing to shell out $1500, without question.  I was completely humbled, and will admit that I cried.  A lot, actually.  I felt so alone in all of this - with Joel overseas.  And it meant the world to know that so many people were willing to care for our little girl in such a generous way.

So, 10 days later, Autumn's helmet came in and I was able to write a check for $1500 without a worry.  It was paid in full and my only worry is now for Autumn's treatment.

She's rocking the helmet, I must say.  Who wouldn't rock a $1500 accessory with such pride?

Cast all your anxiety on Him, for He cares for you  I Peter 5:7


Michelle said...

This just brings tears to my eyes to read about the good people that reached out and the way the Lord provided.

Karren said...

I can't believe Tricare doesn't cover something like that! But oh man isn't God so good--you didn't need their help!!

Anonymous said...

Oh my goodness, as hard as that situation is It is so wonderful to hear the support from friends and even the doctor in helping you.
I want to cry!
She looks adorable in her helmet :)

Emmy said...

So so happy that people were able to reach out and help you and that she can get the care she needs.

Me said...

This story has been a blessing to me. :o)

PS: I'm still mad at Tricare for the debacle with my wisdom teeth. Those morons almost killed me.