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Military Families, Insurance Company In Coverage Dispute

POSTED: 4:18 pm PDT September 19, 2006
UPDATED: 2:26 pm PDT September 26, 2006

Many of San Diego’s military families are just barely earning enough to cover the cost of living.

But now, some families are struggling with health insurance as well.

Several military families are stumped to pay for a necessary medical procedure for their children. It is a common medical problem paid by private insurance, but not the insurance company that serves the men and women in uniform.

T.J. Whiting is a happy baby and doesn’t put up much of a fuss when he is fitted for his new cranial helmet.

The helmet is designed to reshape his head that was misshapen from sleeping on his back. The helmet is now recommended by pediatricians to keep babies safe in their cribs.

But behind the happy exterior, T.J.’s parents are worried. They are concerned about paying for the helmet and the treatment costs that are about $5,000.

A misshapen skull is called a plagiocephaly, affecting one in every 30 babies. Mainstream medicine has a standard treatment of care for this disorder, including bands that look like helmets.

Private insurance companies pay for the treatment and helmets, but the Whiting family’s insurance does not.

“They should be covering it. It’s not OK at all,” said Krystle Whiting.

Krystle Whiting is referring to her insurance company, TRICARE West. The company is the insurance company for the entire military.

“It’s a big run-around. It’s very disappointing,” said Whiting.

It’s especially disturbing for T.J.’s father, who was serving in Iraq when his son was born.

“We came here and we battle. We get on the phone and all I’m going to do is curse them out, but that’s not going to do any good,” said Cpl. Tyler Whiting, United States Marine Corps.

Another couple, a Navy family, faces the same problem with their 10-month-old son, Drake, and their insurance provider.

Nicole Howard said her husband used his re-enlistment bonus to pay for Drake’s treatment. Howard said her husband spent $5,400 out of his pocket because TRICARE refused to pay.

“I’m grateful we had the money, but there are other families not able to pay,” said Howard.

Physical therapist Allisa Eckhart said if these babies are not treated early, they risk developing other health problems.

“They can develop problems with Temporo-Mandibular Joint, orthodontics, eyes, ears and hearing,” said Eckhart.

Many military families said TRICARE is not helping, leaving them to scramble to find money to help their children.

10News spoke with top management at Phoenix-based TRICARE.

The company said they made exceptions for some Air Force officers in Arizona six months ago and will consider helping San Diego families, as well.

10News pushed for more coverage, asking that all military families in need of assistance get the help they need. 10News investigators also called on San Diego’s congressional delegation to look into this issue.

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