Eczema,  Titus

Titus’ Eczema Fundraiser (Insurance Issues)

Screen Shot 2014-01-24 at 4.20.08 PM

Two weeks ago we started a fundraiser to cover travel and out-of-pocket medical expenses to take Titus to National Jewish Health in Denver (see last post). We set a target of $5,000 and began sharing the page. In under 48 hours, many generous people raised the entire $5,000! We are very excited to see the way God is working through people to help Titus.

Today, we found out that Titus insurance won’t cover the hospital bills, so we need an additional $10,000 to $15,000 in order to get him to Denver. (They would like a $15,000 down payment, but do offer 30% off the total bill if paid in cash). Keep reading if you want to know the details.

From Titus’ Fundraiser Page: “Recently, Matthew (dad), was searching the internet and reading others’ eczema stories and ran across several stories about the program at National Jewish Heath. Everyone who took their babies with severe eczema through this program came back with amazing stories. They were sleeping again! They had their life back! Their babies could eat foods they had never eaten before!

“These parents all recommend the program highly. We really want to do it, as this gives us hope for Titus. Our primary physician has referred us to the program, and we are working out the details as quickly as we can. At this point, we are hoping insurance will cover the hospital bills, so we are focusing on raising money for travel and out of pocket medical expenses.”

5-2013-04-10 17.02.28Basically, our kids only had state Medicaid until last month when we added them onto our Samaritan Ministries account. Since this is a pre-existing condition, Samaritan Ministires can’t cover it other than to publish it as a Special Prayer Need where people can voluntarily pray and give.

We were hopeful that Titus’ state Medicaid would pay for the hospital bills. Our primary physician, a naturopath, has already referred us to the program at National Jewish in Denver. However, he is not in Medicaid’s network (we’re not sure if this is relevant, but read on).

We initially called Medicaid and talked to them about it, and they said, “No, we won’t cover it since it is out of Washington state.” After discussing it further, I found out that under rare circumstances, a referral for out-of-state treatment could be brought before the Medicaid board to be voted on. Based on this information, we visited our pediatrician (in the Medicaid network) to see if he would do the referral and special paperwork that the board would require. Our pediatrician said, “I can basically guarantee you they won’t cover it.”

We then talked to National Jewish and told them about the roadblocks we had encountered, and they wanted to pursue it further.

Again, we already had a referral from our naturopath so Matthew looked into seeing if that referral might work. We also considered getting a second opinion from another pediatrician. Finally, Matthew stumbled on the out-of-state referral paperwork for WA medicaid. This paperwork requires the following:

An evaluation and recommendation for the client’s treatment from ALL the following Centers of Excellence is required:  … Mary Bridge Children’s Hospital and Health Center in Tacoma, Children’s Hospital and Regional Medical Center in Seattle, and Dorenbacher Children’s Hospital in Portland. Please provide a copy of the evaluations with the recommendation for the client’s treatment. The evaluation and recommendation for treatment from the required facilities must include a statement as to whether the requested out-of-state care can or cannot be provided at the in-state treatment facility composing the evaluation.
When the service is not available in the state of Washington and it is medically necessary to refer the client out of state, please contact the following hospitals first:
Lucille Packard Children’s Hospital for children

Based on this information, we realized that Titus would have to be evaluated by several (4) more hospitals before a referral to Denver would probably even be considered by Medicaid. However, all of the amazing testimonies from other parents’ of kids with eczema are about National Jewish Health in Denver.

Because of the severity of Titus condition and because of the success of the Eczema program at National Jewish, we believe it would be best to pay cash and get Titus to National Jewish as soon as possible. Thus begins our fundraiser for the $20,000 in medical bills. Thank you for taking the time to follow our story.

Watch the video below for more info about the Eczema program at National Jewish:

Leave a Reply

Your email address will not be published. Required fields are marked *