We have entered another battle.
Bryan has been using hyperbaric oxygen therapy (HBOT) to help treat his TBI. The therapy administers high pressure oxygen to help the blood flow in his brain. And, it’s working.
Bryan has better memory function, fewer PTSD episodes, less impulsiveness and better brain function. Still, his improvement does not seem good enough to justify the insurance companies paying for it.
Medicare denied the $9,0000 claim for HBOT. Now, Tricare is denying the claim as well even though they said they would pay once Medicare denied it. The hospital has appealed it as far as they can and they told us that the patient needed to appeal it now.
I’ve mailed his appeal paperwork but we are still receiving bills - $9,000 worth that is due now. We have another $20,000 in outstanding bills from the therapy. We don’t have that kind of money lying around. I know for a fact that Tricare paid for this same treatment for another wounded warrior. Why are they discriminating against my husband? Why are they making us fight? I am so tired.
This is our first appeal with Tricare and luckily another wounded warrior wife who has done this many times before is helping out. We couldn't be more thankful for the guidence.
What I don’t understand though is that even though my husband has three insurance companies covering him not one wants to pay for a therapy that works? The HBOT gives him gains that he has never made with pills or therapy.
I just hope we can get this worked out as soon as possible. I am so stressed over this and it isn’t healthy. I know it is stressing Bryan out too even though he doesn’t really have to deal with the paperwork issues.
I feel that the insurance companies want to cause families stress. I feel that they don’t want these warriors to make gains by thinking outside the normal box for treatment. I feel they want to waste time and money in appeals and make it a difficult trying process for families.
If Tricare does not pay for these services we could be in long term financial ruin. I need prayers, hope, the will to keep pushing, and patience. Luckily, I don’t give up so easily. So now, I will put on my proverbial boxing gloves and get this taken care of.
14 comments:
Isn't it just like the Army or the VA? It'll happen, you just have to keep pushing. Think of Dory from Finding Nemo: Just keep swimming, just keep swimming, swimming.
I contacted the group Healing Heroes Network about my TBI, it took a couple months after submitting the documents they needed, but I got a call out of the blue and they have been sending me to HBOT for two months now, 3 times a week, an are going to continue all the way until Dec. 31st. I don't know how much yours costs, but they are paying $675.00 a week for 3 90min sessions. Im going t find the link and send it to you, they might be able to help.
THAT IS SUCH A SHAME THAT THEY TREAT SOMEONE THAT WAY.MY PRAYES WILL BE WITH U GUYS HOPE THINGS WKS OUT FOR U. KEEP FIGHTING HES WORTH IT. I DONT REALLY KNOW U BUT I FEEL FOR U GUYS. THIS IS AWFULL
I'm a new reader and I don't know you or your husband, but I wanted to tell you that I'm praying for you both and the insurance claim. There's just got to be a better system to care for our wounded warriors where they and their families don't have to worry about the financial aspect of their healthcare.
First off, glad to hear that the HBOT is working well for him. I wonder if it would work for older TBI as well?
As far as "TryCare", always get everything in writing from here on out. If they say 'yes we will cover this if X & Y.' Tell them you want it in writing. It will come in handy in the future.
As far as the current bills, keep hounding Tricare to get it taken care of and keep reminding the person whom the bill is from that you are honestly working on it. (Get them proof if you can that you are working on getting it taken care of as well, it helps.)
I'm so sorry. If I had any money to give, I would glady send it your way. I hope everything works out for the best for you and your husband.
Thanks everyone for the kind words. Tom, Healing Heroes is going to help us pay a portion of the bill. Bryan just couldn't take off more work to go for 40 more treatments. I hope you are seeing good results!
I pray that he gets the care he needs! I appreciate yalls service to our country.
kim
Cheryl, you are a woman of strong will a fighter and I know you will prevail. I will support you with my prayers and I am not yet in the other side of the court (VA) so i wouldn't know anything about this, but one thing is certain, please don't forget that you have a strong army behind you. We the caregivers support you and Brian and if you need signatures to change the policy then we are all a call apart. God bless you friend and your struggles are shared by so many but you will always make a difference and this time will not be the exception. Hugs!!!
Is there any success with TBI? I have been dealing with this since 2005 with medication and therapy to relearn how to display the appropriate emotion for the situation. As far as Tricare and Medicare not covering, I'll sell this house for a day without a migraine or a lengthier glimpse of lucidity. How old is his TBI because I lost 2 years due to multiple seizures a day and the VA's sedation to protect myself.
Joseph, he didn't get any treatment until almost 3 years after his injury. He was part of a trial for HBOT for TBI and PTSD vets and that is where he orginally made gains with the treatment. After we had proof it helped we got it here locally. I did get more info. yesterday that the billing dept. had to submit more info. to Medicare so they will deny as a non-covered service so it can be paid by Tricare. We will see...
If you have not already, contact your Congressman. He can open an inquiry with Tricare on your behalf.
I'm sorry that you are having so many problems with bills. Its sad that the government won't take care of it. I have a wounded warrior too, he's still in the marines. I hope they come to their senses and help you pay off the bills.
Sorry about not getting back to you. Thanks for the information and I'm sorry that Tricare is not picking up the tab. As someone has already suggested, contact your congressman for when we were having problems with treatment when I first got home, my commanding general was able to transfer me to civilian treatment by coordinating with a senator (actually the senator from a state over but close enough, my senators wouldn't do anything because they were against the war after they supported it).
As far as the HBOT treatment is concerned, we have a center in Richland, WA that will do it for $100 a treatment but they are not sure if Tricare accepts since for them its been hit and miss for them as well.
Thank you again for the info as I am scheduled to start after my next MEB.
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