Get this... after my trio have already started receiving their 2nd year of Synagis shots (2nd month), my dh's insurance decides they no longer meet the criteria and have denied the rest of it. They stated that the American Academy of Pediatrics *NEW* criteria are 3 things now: chronic lung disease, heart disease & something else that I didn't even hear her say as I was so P*SSED I was not even listening. I asked her what happened to multiple gestation, daycare, preemie, etc... she said they do not go by that, WHAT THE?!?! So, I am appealing it but I was wondering if anyone knew of any Synagis Clinics in NJ? And where can I see with my own eyes this *NEW* criteria??? Knock on wood, my trio have been healthy with a cold here or there and we are taking them for flu shots tomorrow but I am so upset now I could beat the cr*p out of that insurance lady. AHHHHH, I feel much better now, THANKS!

Tiffani & Ray(NJ)

Tiffani- welcome to the club!! I know the feeling of being so PI$$ed b/c my kiddos could not get their synagis shots the second year. Get this, my insurance is willing to pay for the shots but the clinic that gives the shots says they don't meet the criteria. Now wouldn't ya think the clinic would want the money?!!!

I do remember being very surprised when you said that your kiddos were getting the shots the second year b/c i couldn't make it happen for my kiddos. I think most of us on here didn't get the shots the second year. Your kiddos will probably be ok, i would just say to try to stay in as much as possible (groan) i enjoy getting out of the house w/ my kiddos. I try to go out at the off peak hrs. when i need something usually early morning hrs. right after i drop my 8 year old off at school around 8:15am.

Sorry i can't help you out w/ the synagis clinics but just know i'm counting down the days until spring right along w/ ya sister!!!

Beth
Dylan-8
Tommy,Karli,Abby- 10/14/02 32w 2d

Beth
Dylan-12
Tommy,Karli,Abby- 5yrs. 32w 2d

We're w/Kaiser and last year they had the criteria posted in the office-try calling your ped. My guys barely passed bein born just short of 32w. They had them logged as 31 weekers.

Marie

Marie

I spoke to the Ped numerous times. He is fighting it for us but it is the Insurance company playing games when they were the ones who mentioned it to us at the start of the season, all of a sudden they changed their minds. I guess they just figured out how expensive the shot is times 3!

Tiffani & Ray(NJ)

I feel your frustration...I went through the whole fighting with the insurance company thing along with apealing a few times and nothing worked my boys apparently were born too healthy and the insurance company couldn't care to keep them healthy-just my opinion. Even though my boys met all but two of the criterias listed on just about every website it didn't matter -my pedi office is still talking about the boys being denied and how ridiculous it all is. Mine like yours thankfully have been pretty healthy we've just been fighting a cough with some congestion but so far nothing serious. On top of everything else they are still too young for flu shots. I'm just keeping my fingers crossed that we make it through the season without problems. Best of luck with your appeals.

Sandy
Stepmom of Ean 13
Mommy of Aaron, Gavin and Connor
July 18,2003
born 34weeks and 6days