Coverage will continue as long as the requirements are met. However, most insurance companies require re-certification each year. The child does not have to be receiving SSDI or SSI benefits to qualify as a disabled child under a parent's health insurance policy. Many people feel discouraged when their insurance company denies coverage and thus they do not appeal this decision. Parents of children with CF, adults with CF, the CF care center team, and CF Services can be effective advocates for coverage of necessary treatments.
Advocacy involves appealing a denial of coverage by the insurance company.
Providing documentation of the medical necessity of the prescribed treatment, equipment or medication, will increase the likelihood of a successful appeal. In situations where the denial of coverage has been for emergency care, such as I.V. antibiotics or hospitalization, a phone call from your physician to the health insurance plan's medical director is sometimes effective. It is helpful if you are familiar with your health insurance policy and its coverage. Submitting information to the insurance company that refers to the policy and that shows that prescribed treatment will save the company money can be helpful. If the appeal is denied, take your appeal to the next level.