
Originally Posted by
mehera
Jessica,
Thank you for the link! How did you find that? I find their website so frustrating. Unfortunately based on my last call it sounds like I may fall into this category:
Did you remember if your plan specifically mentioned orthotics under DME?
I only have my plan summary, which has no clauses listed under DME. I found that link when we first found out my daughter needed a brace and I used good old Google to see if I could find out what Aetna would cover. We then called Aetna and got a pretty straight forward answer as to what would be covered. I'm sorry you're getting the run around! Been there, done that. No fun.
Our orthotist asked us to bring a "letter of medical necessity" which my daughter's orthopedic surgeon's department provided with no problem.
Mom to 11 year old DD who was:
diagnosed 5/09: 8*L, 8*T
braced 7/10: 17* L, 25*T, 20*C
x-ray 11/10: 7*L, 17*T, 20*C (x-ray immediately OOB)
most recent x-ray 06/11: 17*L, 24*T, 22* C (x-ray 24 hours OOB)