Our Son will Need a Cranial Helmet.

Jameson had his four-month checkup this week and right when the doctor walked in he told Bea they had to talk about his head. Great! We switched to Tricare Select for Bea and Jameson starting this year, because the medical care for dependents on base is terrible. So once the New Year came, Jameson would once again able to be seen by what we felt like a was competent doctor who actually listened to our concerns for him. See, Jameson was born with torticollis, which meant he was tight on one side of his body and that meant he slept and really only used his left side of the body. For around two months Jameson was already receiving therapy for the torticollis and he had come along way since it started. Jameson now used his right arm and hand way more often and he could now crush tummy time, being able to hold himself up with both arms instead of just his left one.

Jameson’s therapist kept talking about the potential need for a helmet, but to be honest I have thought it was just a tactic to get more money out of us or Tricare. I thought this because they always just talked about the head shape and the flat spot. But never did they mention that Jameson potentially had craniosynostosis, which means that the plates in his head were prematurely fusing and that could cause big problems down the road if not corrected early on. The issues that I am talking about are issues eating, speech delays, and eye and ear misalignment. Jameson is already showing signs of ear misalignment, so we have caught it early on and can hopefully correct the issue before it gets any worse.

Bea hit the internet running and started researching helmets. What were they going to cost and would Tricare pay for them? We learned that Tricare would not in fact pay for the cranial helmet unless the child had undergone surgery first to try and correct the issue. This to me and many others made absolutely no sense. Someone I work with put it best “that’s like Tricare saying they won’t pay for glasses unless you get Lasik first” and that is exactly what it is like. Why would I put my child through extremely invasive neurosurgery if a helmet can help prevent that? After researching myself I saw that there are a few parents that choose to have their children get the helmet so they could have a perfectly shaped head. Merely for cosmetic purposes, not out of need. And this was the reason many insurance companies would not cover the cost of the prosthetic. With a quick internet search, I saw that most people turned to goFundme or loans to be able to get the helmet for their children. Late last year, I saw another Air Force member raising money so he could get his daughter( I believe) a much-needed cranial helmet, and untimely they were able to reach their goal and help their child.

Now Bea and I talked about how we’re going to be able to afford the helmet for Jameson. Should we fight with Tricare, who in the end would most likely deny the claim? I could reach out to the Airman and Family Readiness Center and see what options they had. Bea’s family offered some money to help pay for it, but we would still have to come up with the rest. Or did we just swallow our pride and create the goFundme? I did end up reaching out to the A&FRC to see what options they had available. When they got back to me, they were able to offer me a 0% Internet loan, and possibly a grant, but the grant wasn’t guaranteed and it wasn’t 100% if it would have to be paid back as well. So those were options, but having another monthly debt was something we wanted to avoid if possible.

While we were discussing and thinking about the money situation I went online and started to research more about the cranial helmet and what is involved. That’s when I came across this article from the Cranial Therapy Centers that talked about the best practices for getting insurance to cover some or all of the expense. In the article, they talk about the proper medical coding the physician should include in the order, as well as the exact wording they should include as well. They also discuss a few grants and foundations created by insurance companies to help their clients get the funding needed for prosthetics. There was also another blog that I came across The Everymom that talks about the cranial helmet more in-depth from a parent’s perspective. The article answered a lot of the questions I had and also helped ease a lot of my concerns.

After a few discussions and weighing our options, we decided to give the goFundme site a chance. Bea wrote out and set up the site, and to our surprise and thanks, we were able to raise more than our goal in less than 24 hours. We were beyond grateful for everyone’s generosity and help. This means that come the 21st of this month that after his initial fitting and sizing, we will be able to just get the cranial helmet Jameson needs. That means no worrying about fighting with Tricare, not worrying about how we were going to pay back another loan, even if it was interest-free, and no added stress to an already stressful situation. One day, when Bea and I are able we will pay this unbelievable generosity that people have shown us forward to another individual. Thank you again, and God bless everyone that donated or shared our story.