I’m on the mission of getting Elijah a Closed Circuit TV (CCTV) AGAIN! I’ve been down this road before. I go on a “high” all excited and determined to succeed. Then I seem to hit a dead end and except that he just won’t get one…yet.
As I mentioned a few posts back, I’ve been attending a class on being a parental advocate for a special needs child. We got into medical insurance and Medicaid issues at the last session. (Eli receives SSI for his blindness therefore also has Medicaid alone with my private insurance.) I will admit I was getting quite irked at “the system” when all these parents were talking about what they all got from their insurance(s). I have not been able to get A THING for Eli through either insurance. Not even a magnify glass. What’s the difference between a magnify glass for Eli verses a pair of glasses for me? My vision insurance doesn’t even help Eli a tiny bit. His disability IS HIS VISION!
There was one mother’s story that really upset me. She got Medicaid to purchase her daughter a SECOND (same size) wheelchair for their VACATION home! She was so excited to tell us how nice it is not to have to pack a wheelchair in their van anymore. GGGRRRR!!! Here they have TWO homes and yet Medicaid is buying them a second wheelchair.
I would LOVE ONE CCTV for Eli, for our ONE lil apartment. And I’m told Medicaid doesn’t pay for them.
I’ve contacted my insurance company. They of course called back with, “No we don’t cover them.” I asked why. “Because they are not considered a durable medical equipment (DME). ” Oh, I was ready for that response. I had found this awesome article written by Greg Trapp and I had it right in front of me. I then gave her the definition of a DME.
” An assistive-technology device is defined as any item, piece of equipment, or product system that is used to increase, maintain, or improve the functional capability of a person with a disability. If the device serves a medical purpose, it may also meet the definition of “durable medical equipment” (DME). A closed circuit television can be included within the definitions of assistive technology and durable medical equipment.”
I went straight in to Greg’s explaination on how a CTV can also be considered a “prosthetic device.”
“Medicare may also cover a CCTV as a “prosthetic device.” Medicare defines prosthetic devices as devices which replace all or part of the function of a permanently inoperative or malfunctioning external body member or internal body organ. For instance, Medicare covers pacemakers as prosthetic devices, even though a pacemaker does not replace the heart. Likewise a contact lens prescribed after cataract surgery is also covered as a prosthetic device since the contact replaces the function of the natural lens. Accordingly a CCTV may be covered as a prosthetic device since it replaces the functioning of the damaged portion of the eye.”
“For example, the American Academy of Ophthalmology recognizes the CCTV as a prosthetic device. In addition, the CCTV is not a comfort item. A comfort item is an item such as a tape recorder which does not contribute to the treatment of the visual condition. By contrast a CCTV is a treatment for the damaged portion of the eye. It does not matter if you will use the CCTV for recreational reading.”
The kind lady I was speaking to on the phone then put me on hold to talk with the claims specialist. She return with a little hope. I was told to get a letter from Eli’s eye doctor and they would “look into it.”
The lady I was speaking to asked me about Eli. She was curious. She didn’t even know what a CCTV was. I told her all about Eli’s blindness and what assistive technology he has and what he could use. She was amazed that I couldn’t get anything covered by health insurance. In the end she gave me her direct line if I ever needed anything.
Of course I immediately called Dr. W’s office and spoke with his nurse. She was going to inform Dr. W of the needed letter. Now I’m just waiting for that letter.
My next phone call was to Medicaid. They wouldn’t even tell me if they would cover it or not. Instead they told me to get the provider to send them the bill and they would decide then. Well, that’s going to be difficult seeing I don’t technically have a source for purchasing this CCTV yet. So, Medicaid is put on hold until I hear from my insurance company.
K, one of Eli’s vision teachers gave me the technology guru’s email from the Wisconsin Center for the Blind and Visually Impaired. I’m hoping he can connect me with a company that will assist with working with the insurance companies.
She’s also contacting a member of the Lions Club. I’ve tried…and tried and tried already. I can’t complain much about them as they provide an awesome summer camp to Eli every summer at no cost. I’m grateful for that. When I spoke to them about funding towards a CCTV I always get, “we’ll get back to you.” Though nobody ever did, no matter who I talked to.
I’ve been told by other parents that I need to be more persistent and get the members so sick of me calling them that they “take action” just to get rid of me. I guess I just didn’t feel comfortable going that route and sat back to wait for their return call. Yeah…almost two years later I’m still waiting.
Hopefully, K can succeed more than I could. I’m hoping my insurance will decide to cover a CCTV and the portion that they won’t cover will come from the Lions and I won’t even have to go through Medicaid. As it’s almost a given Medicaid will deny the claim and I’d have to appeal anyways. I’M HOPING!! AND PRAYING!!! AND CROSSING FINGERS!!
I had Eli’s parent teacher conferences last night. His classroom teacher mentioned she would be more than willing to write a letter to the insurance company as well. She is proof that he succeeds better on the CCTV. His reading fluency increases quite a bit. It is so difficult to read with a two inch magnify glass. The CCTV is such a beneficial assistive device for him and she is willing to verify that for us.
Reading at home is such a struggle for him. It takes him forever. It just seems so unfair for a reading assignment to take over an hour for him and maybe 15-20 minutes for the “normal” sighted 4th grader.
It’s not only reading though. Worksheets can be placed under the CCTV. He can write without having his face to the desk. His eye strain head aches barely come during school. At home…that’s another story. And it’s when he has to spend a lot of time on homework. Which is almost every school night.
With all this internal excitement burning in me again I’ve once again been “shopping” for the perfect CCTV. Here’s a few we’re looking at. My biggest dilemma is whether to go with a desktop or a portable one. A portable one seems nice, you know to take to Grandma’s if needed or where ever needed. But, the desktop ones have a bigger screen and more setting options. I’m leaning towards desktop.
The two portable ones I’m looking at are the Strix and the Amigo. Here’s a nice evaluation on both that I found.
The desk tops are all fairly similar. We know we would like a flat LCD screen. This one appeals to use because of the yellow underlining of the line you are reading. Eli’s states it is hard to follow the sentence lines. Just an added bonus he likes.
http://www.visual-techconnection.com/cv+tft.htm
Please send your good vibes, prayers, chants and cross your fingers that soon one of these will be in our home sitting on Eli’s desk. He promises to always have a smile on while using it and not to fight with me when it’s time to get his homework done.
