It’s Medically Necessary!
Jodi Shenal
I'm a stay-at-home mom with two amazing children. My son is on the Autism spectrum and my daughter has a rare genetic disorder and multiple disabil...
Your child needs a piece of medical equipment. Their doctor has written an order for it and attached office visit notes and all the right documentation to support it. Everything has been swiftly faxed over to the DME (Durable Medical Equipment) provider. Your child has insurance coverage AND a waiver plan. Everything should be smooth sailing now. All that’s left for you to do is kick your feet up and wait for its prompt arrival, right?
WRONG.
In my experience, it NEVER goes that way. If only it could be so easy.
Obtaining adaptive equipment and supplies for a child with disabilities and special healthcare needs is a tedious, arduous battle. The fight for all things medically necessary seems never-ending. Supports that improve quality of life are often inaccessible; most parents and caregivers can’t afford an arm and a leg in ridiculous retail prices. We don’t wish for any of these items for the sake of luxury.
Our children NEED them, and they are required to assist them in daily living.
They are vital fundamentals.
Safety Beds, Pulse Oximeter Machines and Oxygen
Orthotics, Wheelchairs, Walkers and Shower Chairs
Communication Devices, Diapers and Supplemental Nutritional Formulas
These are just a few of the essentials that my thirteen-year-old daughter relies on. None of them have been a breeze to access. I am accustomed to spending countless hours making follow-up phone calls and sending numerous emails to plead our case for the need. Relentless headaches and frustration almost always accompany my efforts.
It shouldn’t be that way.
Insurance will often require additional information, multiple times, which adds days, weeks and even months to their decision-making process. Worrying and waiting to see if your child will get what they desperately need becomes wearisome. Sometimes, you wait and wait to ultimately receive a DENIAL. It’s unfathomable that something that your child’s doctor has deemed necessary won’t meet the insurance company’s guidelines. Feeling utterly defeated, the battle continues. It’s back to the drawing board; back to square one.
There have been rare occasions I can remember where the process of being approved and receiving the equipment was not exhaustive, but those experiences have been few and far between. If I could bestow advice to parents new to this path, in the trenches, fighting for what their child deserves:
KEEP GOING.
