D
dryrock
Guest
What is the name of your state? NE
I have a 6 year-old daughter with a severe handicap. She is non-verbal and would benefit greatly from an augmentative communication device (cost range $6500-$7500), in addition, though she is mobile, she could benefit from a wheelchair as she lacks stamina and has now outgrown baby strollers.
In many other states, my daughter's particular syndrome would qualify her for a Medicaid Waiver which would cover those things she needs that our primary health insurance doesn't cover and is not based on the income of the parents. However, in Nebraska, where everyone only cares about football, that waiver only will cover her if she had a swallowing difficulty, a seizure disorder or was non-mobile. ....non of which my daughter has or is. In Nebraska, the Medicaid waiver does not cover people with mental retardation or autism. Moving to another state isn't an option right now....we can't afford the move or the career move.
In any case, I'm grasping at straws trying to figure out how come we are falling in between the cracks here....if we were dirt poor, we'd have the world for her, and if she couldn't swallow or had a seizure now and then she'd have the world as well.
My question....do we have a snowball's chance in Hades of getting our health insurance company to cover these expenses (it would help us tremendously even if they paid partially) if we hired a lawyer and appealed? Or would the cost of the lawyer outweigh the benefit or would we even have a case? The insurance company says these things aren't medically necessary, though I disagree.
Second, do we have a case against the state for discrimination against my daughter on the nature of her disability?
Please go easy on me because I know I might be asking stupid questions....however, I'm leaving no stone unturned in my quest to get my daughter the things she needs, so I had to ask if there's anything legally I can do.
Thanks,
Christy
I have a 6 year-old daughter with a severe handicap. She is non-verbal and would benefit greatly from an augmentative communication device (cost range $6500-$7500), in addition, though she is mobile, she could benefit from a wheelchair as she lacks stamina and has now outgrown baby strollers.
In many other states, my daughter's particular syndrome would qualify her for a Medicaid Waiver which would cover those things she needs that our primary health insurance doesn't cover and is not based on the income of the parents. However, in Nebraska, where everyone only cares about football, that waiver only will cover her if she had a swallowing difficulty, a seizure disorder or was non-mobile. ....non of which my daughter has or is. In Nebraska, the Medicaid waiver does not cover people with mental retardation or autism. Moving to another state isn't an option right now....we can't afford the move or the career move.
In any case, I'm grasping at straws trying to figure out how come we are falling in between the cracks here....if we were dirt poor, we'd have the world for her, and if she couldn't swallow or had a seizure now and then she'd have the world as well.
My question....do we have a snowball's chance in Hades of getting our health insurance company to cover these expenses (it would help us tremendously even if they paid partially) if we hired a lawyer and appealed? Or would the cost of the lawyer outweigh the benefit or would we even have a case? The insurance company says these things aren't medically necessary, though I disagree.
Second, do we have a case against the state for discrimination against my daughter on the nature of her disability?
Please go easy on me because I know I might be asking stupid questions....however, I'm leaving no stone unturned in my quest to get my daughter the things she needs, so I had to ask if there's anything legally I can do.
Thanks,
Christy