question about children with growth hormone deficency and insurance

[robertsmom]

I originally posted this on the Disabilities board but I thought I'd see if anyone here could help me. My DS(9) has been taking Norditropin for growth hormone deficency for about 2 years and it has made SUCH a difference. He has grown six inches in 2 years. His growth all but stopped at 4 (between 4 and 7 he only grew 4 inches) and with Noditropin he has almost tripled his growth rate. My problem is up till now he has been on government insurance which paid the whole cost of his prescription, but now I make too much money to qualify so I have to put him on my work insurance. I am wondering if anyone with kids on growth hormone meds can tell me what portion insurance will pay for. My biggest fear is that I won't be able to afford these meds for him anymore (right now he uses three vials a month at 750 per vial and the price will increase whenever he needs a larger dosage). My insurance is Blue Cross/Blue Shield if that makes a difference. Thanks for any help!

 

[HOGFAN]

not us, but a coworkers son is on it and she pays $400/month out of pocket

 

[Jpgirl]

My ds was on a growth hormone study many years back and after the study the Docs recommended that he stay on it since it was beneficial. However our insurance would not cover any portion of the cost and it would've cost us about 10K (with the price going up as his weight went up) a year. Sadly, he went off it. You need to call BC/BS and ask for a nurse case worker (not sure if this is what they're called. Call customer service and explain the situation and they will assign a case worker to you. They gather all the facts and present it to BC/BS. They will be your liason. If they say no you can appeal. I went through this process several years ago to try and get some additional services paid through BC/BS. They were very helpful despite the fact that they rejected the claim. BTW My ds is now 19 and just under 5'. He's still short and slowed his growth after going off the injections but he still ended up taller than he would've without the GH. Good luck Feel free to PM me if you want any further info as I've had to deal with insurance co. for my ds' entire life

 

[mrsmom]

My son was on growth hormone for four yrs, just got off.. it was 4,000 per month and we paid 50.00 insurance covered the rest.
Kim

 

[mom2grace]

You might also call the drug manufacturer, they may have a program to help with the costs.