Can't believe it!!!!

[twinmaker]

My great nephew is undergoing his 3rd surgery tomorrow to repair his cleft palate. He is 16 months old. In the course of a conversation with my dad tonight, he told me that my neice and nephew's insurance company only covered part of his last surgery on his cleft lip. The insurance company said that part of this surgery was considered cosmetic! Both my neice and nephew are teachers, and I don't know what insurance their school system has. I couldn't believe my ears! Give me a break!!! Stuff like this REALLY gets to me. Sorry. Just had to vent! LINDA

 

[Lisa in Katy]

This one is definitely worth an appeal. I worked in a plastic surgeon's office for quite a while and never heard of cleft palate repair being considered cosmetic. Perhaps it's the way the surgeon billed it?

 

[Jackie]

Sorry to hear this. I have a nephew in N.C. who was born with a pretty severe cleft pallet. He is 11 now and has had 5 surgery's at Duke. He is really lucky he looks really good and has had speech therapy and does very well in that department. They have also taken care of his teeth, still has a long way to go with that, has to wait till he is older . He might have to have some more surgery on his little nose because it was pretty bad. When Timmy was born they sent him directly to Duke and they have been wonderful. They will take care of him until he is 18.

 

[Cris N]

That's ridiculous. It is not cosmetic, it is medically necessary. Time for an appeal.