RSV shots denied :(

hollyoid7

I am so mad I could cry..My boys are 30 weekers and we already had an RSV scare at the beginning of the week with Timmie..Is there anything I can do?? I see I can appeal it, but does that even  work???

mhop

I can't believe it!!!  I would definitely appeal.  Good luck

armo

That sux. I don't know if appealing works, but maybe if your pedi writes some detail and specific reason in their history they are at particularly high risk, it would help.

If not, I guess just try extra harder to keep them safe and away from people/babies this winter!  The shot isn't guaranteed to keep them healthy anyway (plus all the ouch factor and going to get them monthly), so try not to fret too much if it doesn't get covered

MassaRN

We aren't covered this year either and they were 25 weekers.  I know it sucks.  I wish the insurance company had to pay for it for at least 2 years.

SBMBride406

We're still fighting ours. Our pediatrician called the insurance company medical director who made the decision and found out he is a kidney dr who knows nothing about RSV. She called the insurance company and requested the final decision be made by an infectious disease dr who has experience treating RSV. The insurance company ok'd that request...now we're just waiting for the decision...