In order to get my electronic foot drop system I was going to have to come up with $6,500, considering that I am a rich and famous teacher (I wish) that should be no sweat. Dianne the rep I was working with from Bioness told me that there was a chance insurance may cover the device if I could prove medical necessity. So I set out to see what I could do.
Rewind a few months back to the beginning of summer 2013, for some reason my insurance stopped covering my Tysabri infusions. I called the 1-800 number on the back of my insurance card to try to get to the bottom of things, after an hour of explaining things to employee after employee I was no closer to getting an answer to my problem. Frustrated and Tysabriless I did what anyone would do, I complained to a co-worker. Luckily it was the right co-worker, she informed me of an option that was available in my insurance to get a case worker to help me manage my health care.
After getting set up with my case worker Therese I explained the issue about my infusions getting cut off and she went to work. Turns out somewhere along the line someone had entered a code wrong causing my meds to become unavailable to me. There was no way I could have fixed this problem on my own; it took an hour on a conference call between 6 people to right the ship! Anyway Therese to the rescue and I was back in business.
Back to the electronic foot drop device, after demo-ing it for a short time there was no way I was going without it, it looked like I was going to be in the fundraising business. After talking with Therese my case worker she told me that I should be taking video of my PT appointments for documenting purposes. So along with Mary my PT we started to record my walking each trip I took to the office.
Therese told me to get a letter of necessity from any and all Dr.’s that I dealt with and she would present my case to the board of decision makers. I collected letters from every doctor on my team, I felt like a pest but finally I had all of the needed documentation. All that was left was for Therese to present my case to the board, this was a very nerve racking time for me, all I could do was sit around and wait for the news.
Finally I received a call from a director at the insurance company and they had agreed to cover me! “It was the videos that really did it”. I couldn’t believe it, I was covered, I never thought it would work out. “We’ll cover $80” is what I expected but it all worked out and they covered the whole amount! I owe Therese for all of the hard work she put in to get this through.
If I could do it maybe you can do it too, ask questions find out what is available through your insurance. If not through your insurance throw a fundraiser, people would rather donate to help out a friend anyway. Be your own advocate and never stop fighting.
Be a Warrior Today,
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