My insurer won't cover a Therabite device to treat trismus. Their coverage policy states the device is experimental and not proven LIKE TONGUE DEPRESSORS.

Has anyone successfully appealed a Therabite denial, or know of a less costly way to buy one out-of-pocket?

I'm down to 23mm and narrowing, and haven't even begun radiation. I need to get ahead of this, now. I'm using my daughter's old toddler spoons and can no longer even eat a banana the usual way.

Thanks for any help!

%#$! is a correct statement. Remember that insurance companies are for profit. I fought with my insurance company for six months to get my Dynasplint. After several letters and many phone calls, they are covering the Dynasplint for 3 months. This means I have to again start the process all over to extend the 3 months. Good luck. The tongue blades are very temporary. Even though I now have Radiation Fibrosis and my mouth opening is still horrible, I do credit the Dynasplint with keeping me at least able to eat. The only advice I can give you is to bug the heck out the insurance companies or be willing to pay for the device yourself.

one more thought. In my opinion...if oral cancer was more politically correct, the insurance companies would have to pay for devices like dynasplint. We really need some help making insurance companies know how important for quality of life these devices are.

Eric, what did you argue in your appeal? & I take your point about the need for advocacy for insurance coverage.

Thanks,

Mama

Did you get a doc's scipt. My insurance covered it but I still had to pay $165. The thing works, but boy does your mouth hurt while stretching. Tongue sticks are just stupid. Did you look at buy online, Amazon had them. Also I saw one on ebay once. I can't sell mine yet, I still use it ever now and then to make sure its not getting worse. I was prepaid to buy it on my own. At $165 out of pocket I feel like I did.

Hi Hockeydad, I do have a doctor's script. Amazon and ebay both around $535...I called the manufacturer and can buy one direct for about $435. My insurance has been pretty great otherwise but this is definitely a blind spot....

Maybe someone on the forum has one for sale? It would be nice if we could help each other that way. I haven't had to use one, not sure if I will need it as I can get 3 fingers in my mouth and haven't done any exercises but if I had one laying around I would gladly ship it to ya Mama.

Two different doctors had consultations with peer doctors at insurance company. We had in our appeal measurements on mouth closing from 35mm to 12mm at the time. We also kept calling and calling and calling.

I am very happy that other Cancers have laws to pay for reconstruction or other needs. I am becoming very vocal and frustrated that Oral Cancer is the Lonely step child.

I hear ya!

Sorry to hear you had such lousy results with your insurance company!