Hi, Has anyone else found that one of their twins qualifies for the Synergis shots for RSV but one doesn't? My girls were born at 34weeks2days, one spent 10 days in the hospital (step down nursery) as a feeder/grower and the other 30 days (again, step down nursery as a feeder/grower). The one that was there longer had to be on oxygen for about a week because she was desaturating. It turns out she was aspirating her food and once we thickened it, she came home within four days on no oxygen. Well apparently twin gestation is no longer a criterion for Synergis qualification, so the pediatrician thinks my one daughter who was on oxygen will qualify but not the other because she had no real medical problems. Is anyone else in this same situation? If the insurance denies Viv, we'll still get Ellie the shots but I'm going to feel horrible if Viv gets sick. I don't think paying for Synergis on our own is an option given it's huge cost. What would you all do? Thanks!
My girls were born at 34 weeks & neither needed oxygen. They qualified with our insurance just because they were preemies. I believe each insurance co has their own qualifications, but you should just call them & ask. I hope they both qualify. Good luck!!
Both my girls go it. They were born @ 33 week and only need oxygen for 5 mins. but were also in Canada and everything was covered. its probably different here.
Hmmm, mine qualified even though they turned 6 months prior to the start of the season (barely). My pedi said they qualified because they were twins. They were born at 31 weeks, one was on oxygen for a while in the NICU but not long and didn't come home on it.
I would have your doctor call the insurance. My were 5 months last year during the start of RSV and received the shots and this year they are 18 months and also qualify for them. One has been sicker than the other but because they live together, both were born at 32 weeks - they are both covered. I believe it is all about the insurance you have -
Both of my guys qualified this year for the shots. My little Will actually had RSV in Feb and was on a vent for a week. They spent 9 weeks in the NICU. He got RSV after coming home from the NICU. My little John had RSV too but his symptoms were only like a real bad cold.
Have your doctor call your insurance. My twins were both initially denied but then picked up. The ped. said this is the first year she is getting people denied. Our insurance says they now have to have 2 risk factors in addition to prematurity though they automatically qualify anyone under 32 weeks. My twins were 33w1d. Our additional risk factors were... older sibling in school, second hand smoke. Now, before everyone goes bonkers, the children are actually never exposed to smoke. My in-laws smoke but never around the children. The ped. used this as a risk factor when talking to the insurance. As well, my older DD wound up hospitalized the first time she had RSV. The ped. was great about talking to the insurance.
Being twins does not automatically qualify them for synagis. Each insurance company has their own set of qualifications, unfortunately. I'm actually surprised you one will qualify because insurance is usually pretty picky about it. Both of mine qualified last year because they were 3 months early, but they don't qualify this year. I would have your ped see if they can contact the insurance and try to get them both covered, especially if one of them is. It's not fair, I know!
My girls were born at 35 Weeks and no NICU at all. They both still qualified b/c they were preemies. They have Medicaid.
My girls didn't qualify because they were born at exactly 36 weeks, no NICU time. The insurance co said that if they had been born just one day earlier, they would've gotten the shots. How ridiculous is that?!
Mine both were qulaified for the shot... They were born at 35 weeks 4 days. They were both very small yet never in the NICU. Savannah took oxygen for 2 hours in the nursery and that was all, both came home with me when i left. We have school aged kids, firelplace, preemies and i stated that MIL smokes (not in my house but before she gets there and then holds them) and they never questioned it... We will start shots at the beginning of Nov and they have applied to have the others done at my house. A nurse comes to do them so we dont ahve to get them out. I bet that both will qualify....
QUOTE(sunshinetwins @ Oct 26 2007, 02:27 AM) [snapback]467702[/snapback] My girls didn't qualify because they were born at exactly 36 weeks, no NICU time. The insurance co said that if they had been born just one day earlier, they would've gotten the shots. How ridiculous is that?! That is ridiculous for sure. I would be livid! I mean do they know what you went through to get them here safe and sound and then to say if you had them one day earlier...
