CARING FOR A CHILD:
|Family Assistance Program Application|
For more information or help with CCF’s Family Assistance Program, please contact the Patient Outreach and Support Manager.
If your child sees several specialists or has been hospitalized, you may receive a series of bills from different divisions within the same hospital. At times, it can be quite confusing trying to understand what has actually been settled and what is owed. Check with your health insurance provider on whether they have or will directly pay the provider and whether hospital, doctor, or lab fees were settled at a lower rate. When looking at hospital bills, you should always carefully review the itemized statements for errors. Monthly bills sent by labs or hospitals also may not reflect recent payments or lower rates, so it is a good idea to write on each bill statement any payment made by the insurance and the amount settled out of your pocket.
You may be concerned about high health insurance premiums for your child with cardiomyopathy. The easiest way to make sure you have medical coverage is to include your child in a group health plan provided by your employer. Under such a plan, all family members are covered regardless of pre-existing health problems. Once your child gets older, he/she can either be covered by a university health plan (tied to his/her college) or a future employer. In selecting health insurance plans, you need to understand the pros and cons among the different options: health maintenance organization (HMO), preferred provider organization (PPO), point of service (POS), and indemnity plans.
Factors to consider are:
Children with cardiomyopathy require frequent visits with a specialist, such as a pediatric cardiologist, so a POP or POS plan is preferable over a HMO. HMOs require referrals for specialist visits that may create delays in getting proper treatment. Also, out of pocket expenses for HMOs may be higher because of more restrictions on coverage.
If insurance coverage is a concern, certain states require private insurance companies doing business within that state to offer open enrollment periods to people with preexisting conditions who may otherwise not be able to get insurance. Some states also offer comprehensive risk plans to help people with high-risk medical histories. You can check with your state government offices and state insurance commission for more information. The National Association of Insurance Commissioners (NAIC) provides links to each state insurance department's website.
Some insurance policies do not cover elective genetic testing. If your health care team feels that genetic testing is medically necessary due to your family history, they can send a letter of medical necessity to your health insurance provider. You can also check your state's legislation on genetic testing and health insurance on what should be legally covered. Another good source of information is the Genetic Alliance. They provide the latest information on genetic discrimination policies related to genetic testing for individuals and families with a genetic condition.