Boy Sleeps For First Time In 3 Years

VamPyroX said:
I guess the insurance company was picky. I would probably do the same if I was an insurance company.

If I were to agree to pay for this "experimental procedure", then I would have a bunch of people running to me asking me to pay for their "experimental procedures" as well.

There are a lot of "experimental procedures" for deafness and blindness. I'm sure a lot of people would go for that if insurance companies agreed to help out.
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But when an experimental procedure is the only think available that will treat such a rare disease like this, it creates a whole different situation. There are experimental procedures for all kinds of medical treatment. But there is also usually an alternative treatment that is not experimental that has proven to be effective. So the insureance company will pay for the alternative. This kid had no alternative. This was the only thing that would treat his disorder. The insurance company should have guidelines in place that will allow payment for an experimental procedure for a rare disease in which there is no laternative treatment.

Insurance company employees spend far too much time trying to practice medicine. They are not qualified to do so. Personally, I don't believe that a claims processor with a high school diploma has any business telling a physican whether recommended treatment is a necessary procedure or not. But they do it all the time. It absurd.
 
Jolie_77 said:
You're right on that one. Also most insurance companies wouldn't go for the ones that has pre-existing conditions as well. An experimental procedure also has it's risks. There's no way knowing if it will succeed or not.
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Any procedure has its risks. We never know whether accepted procedures will be effective or not. In this case, the disorder is so rare that there was no alternative treatment available. The only choice was experiemental procedure, or remaining ill.

Insurance companies have far too much control over medical decisions. It is something that should be between doctor and patient, not doctor patient, and some pencil pusher sitting behind a desk that can't even pronounce the name of the procedure saying, "Nope, we won't pay for that. It isn't considered to be medically necessary."

As far as pre-existing conditions are concerned, the only time that would come into play is if the insurance policy was intiated after the child had already been diagnosed and received treatment. The pre-existing clause is designed to keep people from going tothe doctor and being diagnosed with a serious illness, then taking out an insurance policy because they now need surgery, and then dropping the policy after the surgery is done and paid for.
 
Not that rare

As I also have a type of Chiari Malformation, I thought I'd add a link to the discussion about it specifically. I was born with spina bifida and as a result, Chiari Malformation, type II. However, I am not symptomatic of it.

What is the Chiari Malformation?

I must say even though the condition isn't that rare, the consequence of not being able to sleep is quite rare.
 
Wow - finally the pressure and hell has ended for the first time in 3 years. :shock: Definitely a huge relief for his parents.
 
Oceanbreeze said:
As I also have a type of Chiari Malformation, I thought I'd add a link to the discussion about it specifically. I was born with spina bifida and as a result, Chiari Malformation, type II. However, I am not symptomatic of it.

What is the Chiari Malformation?

I must say even though the condition isn't that rare, the consequence of not being able to sleep is quite rare.
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My dad's wife has Chiari Malformation too. She recently had surgery to decompress her brainstem, and the surgery was very rough on her, and so was her recovery. She is still recovering as I speak, and it's been almost two months.
 
Oceanbreeze said:
As I also have a type of Chiari Malformation, I thought I'd add a link to the discussion about it specifically. I was born with spina bifida and as a result, Chiari Malformation, type II. However, I am not symptomatic of it.

What is the Chiari Malformation?

I must say even though the condition isn't that rare, the consequence of not being able to sleep is quite rare.
Click to expand...

Agreed. I should have worded it better. To see someone with Chiari Malformation that is this severe and with these specific symptoms is rare.
 
Interesting thread here... :eek3:

I´m glad that the hospitail help the parents to get financial assistance. I am total surprised to know that their health insurance refused to cover the surgery cost on boy´s interest because it´s not including...??? What an excuse... *shake my head*

It´s good to know that a boy have a better chance.
 
Oceanbreeze said:
As I also have a type of Chiari Malformation, I thought I'd add a link to the discussion about it specifically. I was born with spina bifida and as a result, Chiari Malformation, type II. However, I am not symptomatic of it.

What is the Chiari Malformation?

I must say even though the condition isn't that rare, the consequence of not being able to sleep is quite rare.
Click to expand...

:ty: for provide interesting link. It´s new to me.
 
Oceanbreeze said:
As I also have a type of Chiari Malformation, I thought I'd add a link to the discussion about it specifically. I was born with spina bifida and as a result, Chiari Malformation, type II. However, I am not symptomatic of it.

What is the Chiari Malformation?

I must say even though the condition isn't that rare, the consequence of not being able to sleep is quite rare.
Click to expand...

:ty: for sharing the link about what is Chiari Malformation. It was interesting to read more about this condition.
 
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