Synagis for 14 month olds

At our one year appointment for the boys, the pedi asked if we wanted Synagis shots again this year. We qualified last year and I didn’t think (in a million years) that my insurance would cover it again, but I just found out that we qualified - no cost to us at all. They boys are not in daycare (with SAHD, but that may change), are 95% for weight and have not been "sick" at all except for once this spring with a slight cold.

What would you do? Get the monthly shots or do without???

HELP!!! :unsure:

 

Wow - that's crazy that your insurance company will pay! I think if it was me, I'd do the shots. RSV can still be serious for healthy kids. You might want to see if your insurance company will pay for a visiting nurse to come administer the shots. That would save your DH the multiple trips to the doctor's office with two toddlers. We had a nurse do the shots last year at our house and it was so convenient.

 

OMG!!! No cost to you?! I'd do it in a second. We actually qualified last year again too (the boys were 9 months old at the start of the season), although due to switching insurance, deductibles, co-insurance, yada, yada, yada........we ended up having over $12,000 out of pocket for one season of shots for both boys. And we did it, even at that. We'll be paying $500/month for what seems like the rest of our lives, but we don't regret the decision. Do a quick search on the potentially devastating effects of RSV, and I think you'll be convinced to take this enormous benefit that is being offered to you.

ETA: The insurance company isn't covering you out of the kindness of their hearts. They have done the cost-benefit analysis and concluded that it may actually be cheaper for them to pay for thousands of dollars in shots than risk the expense of one or both kids getting RSV. Does that put it in perspective?

 

DO IT!!!

Esp. if it is covered. My girls got the shots the 1st year (0-9 months) but did not qualify the second (14+).

They BOTH have had RSV and been hospitalized for it since (one about 16 mont and the other at 26 months).

Go for it---my DD that had a more severe case of RSV still has breathing issues each time she gets sick.ugh!

 

I would definitely do it! My insurance wouldn't cover my girls this year, they were 28 weekers born last October!

 

GIRL GET THEM!!! My guys had them two seasons and they were stay at home and have not gone to daycare yet. Will got RSV before he could really get his first couple of rounds of synagis. He was in the PICU for 2 weeks on a vent. If ins is paying use it up!!!!!!!

 

QUOTE(BridgePort @ Oct 29 2008, 12:19 PM) [snapback]1047133[/snapback]
The insurance company isn't covering you out of the kindness of their hearts. They have done the cost-benefit analysis and concluded that it may actually be cheaper for them to pay for thousands of dollars in shots than risk the expense of one or both kids getting RSV. Does that put it in perspective?


Sorry to hear that you had to pay so much out of pocket, that's horrible but we do what we gotta do for our children, right...

Oh, I totally agree with you on this... cost analysis was definitely a deciding factor here. Blue Cross doesn't just "pay" for anything 100% without careful consideration, kwim!!!

Here’s the deal... I work for an international company and we have lots of visitors from all over the world. I will have to travel some this winter to Germany or other parts of the UK and while I’ve already had my flu shot, I'd hate myself if I got sick and maybe passed something to the boys.

Thanks for the feedback ladies, I think I’ll have the boys start as soon a possible.

 

QUOTE(Kyrstyn @ Oct 29 2008, 12:36 PM) [snapback]1047157[/snapback]
I would definitely do it! My insurance wouldn't cover my girls this year, they were 28 weekers born last October!


Dang, that's crazy!!!! Is there any way you can appeal? That's awful that your girls wouldn’t qualify. I really think the only reason we did qualify is the fact that our pedi said she would fight for us to get it. Maybe you can talk to our pedi about it again?!?!

 

I too was shocked to find out today that our insurance is covering Synagis for a second year at 100%. My kids are not in daycare either but their older brother is so I do plan on starting the shots ASAP. I was very surprised to see them get covered again.

 

Do it! Both my girls got RSV last December at 20 months. RSV is so very scary. Annalise was in the hospital for 4 days - ambulance ride and all. Jilly was able to be managed at home but just barely. It took weeks to recouperate. The insurance co bet on my two and lost.

 

I'd do it. Both of mine had RSV as 3 year olds. I woke up in the night to sounds over the monitor, ran to their room and Timothy wasn't breathing. We own a nebulizer and have a standing prescription for xopenex and got him breathing again. Sarah got RSV. And now she has asthma. Kids that get RSV have a much higher risk of getting asthma. I also woke up once to weird sounds over the monitor and it was Sarah's very first asthma attack and she literally wasn't breathing. We got the nebulizer out and got her opened up and breathing again. It took two treatments to get her totally calmed down and we've been dealing with asthma ever since.

So if you can do anything to prevent that, please do. I'm not sure when I'll ever take the monitors out of their rooms.

Marissa

 

Wow, I am shocked you qualify for a 2nd year. Mine did not qualify for them their 2nd winter, so you are lucky. If you qualify I would get them.

 

QUOTE(Chase&Parker @ Oct 29 2008, 09:45 AM) [snapback]1047172[/snapback]
Sorry to hear that you had to pay so much out of pocket, that's horrible but we do what we gotta do for our children, right...

Exactly! I was just happy they qualified at all. As much as we paid, insurance still paid more - that's how expensive these shots are!! Would they have gotten sick without the shots last winter, I don't know. But I know they did not get sick with them. And I don't feel bad writing that $500 check every month.

 

I felt confident that my insurance would cover it, but my ped recommended against it. Alex was hospitalized with it (one night) last year, and we suspect Evan and Marcella had it too. We think Marcella brought it home from daycare.

Anyway, if your ped says to do it, I would go for it!

 

QUOTE(summerfun @ Oct 29 2008, 08:27 PM) [snapback]1047627[/snapback]
Mine did not qualify for them their 2nd winter, so you are lucky. If you qualify I would get them.


Same here. You are a lucky duck! :lol:

 

We qualified again this year, my girls were 29 weekers but not in daycare. I had second thoughts about doing it, having the girls suffer through all the shots again but we are doing it. Figured at least I will feel like I won't have to keep the girls shut in all winter.

 

QUOTE(tgbmomofthree @ Oct 29 2008, 04:00 PM) [snapback]1047830[/snapback]
I felt confident that my insurance would cover it, but my ped recommended against it. Alex was hospitalized with it (one night) last year, and we suspect Evan and Marcella had it too. We think Marcella brought it home from daycare.

Anyway, if your ped says to do it, I would go for it!

I'm curious why your ped would recommend against it. I've never heard of any downside to the Synagis shot at all (except just the sting of the shot itself), so it surprises me that anyone would turn it down if offered. My ped works like crazy to get everyone they possibly can qualified - it's so important to them that they even tried again to get my boys qualified this year, their third winter!