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Christine,
This issue makes me so angry. I too went through the same run-around with the insurance company last year (my twin girls were born at 32 weeks on 2/1/05 and barely qualified for the shots that 2005 RSV season but not the following 2006 RSV season). My suggestion to you is keep on fighting for the shots with your insurance company, challenging every appeal they throw at you, and get your pedi and the neonatologist who cared for her while in the NICU involved and talking with each other & writing letters to the insurance company. Just keep at them and make it impossible for them to deny you. Because they are counting on you giving up...DON'T...they forget that YOU are the parent and you have a voice. So keep shouting until someone listens. You are your child's strongest advocate. I just found out that the makers of Synagis, MedImmune, Inc., has a Synagis Financial Assistance Program (non-income based). I believe Boston Children's Hospital has a fund for families that can not afford treatment. The shots run about $2K per shot and they are usually suggested from November through March, so it can add up quickly. Try these resources for more info:
They may be able to help or at least point you in the right direction. Good luck and let me know how things are going.
Tracy
mom to Charlotte & Grace former 32 weekers born 2/1/05
-----Original Message-----
From: Parents_As_Partners@yahoogroups.com [mailto:Parents_As_Partners@yahoogroups.com]On Behalf Of Christine Miller
Sent: Tuesday, July 25, 2006 7:52 PM
To: Parents_As_Partners@yahoogroups.com
Subject: [Parents_As_Partners] synergis shots
Hello to all members. My name is Christine and my daughter, Audrey, was born on April 24, 2005 at 25 weeks. She spent 97 days in the NICU and is doing incredibly well. She was only on the ventilator for 10 days and is just about walking. (Her corrected date of birth is August 6.) She received the synergis shots last year without any problem however, at her 15 month check up her pediatrician indicated that she would probably be denied since she is healthy. I know I should be happy that she is healthy, has had no respiratory issues or chronic lung disease but I feel that she should be entitled to the shot for at least one more year to be on the safe side.Is there anyone out there who has run into this problem who could offer some suggestions or advice on how to proceed with the insurance company to get the approval for the shots? My pediatrician is going to try to get her approved but he is not very encouraging.Thanks.
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