Does Insurance Cover Baby Helmet?

Flat heads are common in babies who snooze on one side, a problem that can be easily addressed with corrective helmets. Unfortunately, helmets aren’t often covered by insurance, and the expense could be prohibitive for your family. However, early intervention can often *prevent* the need for a helmet, lowering the likelihood of having to spend out of pocket.

Deformational plagiocephaly, or positional skull deformities, have grown increasingly common as a result of doctor advice that infants sleep on their backs to prevent SIDS, according to the American Academy of Pediatrics. Because their skulls are still soft, many babies end up favoring one side of their heads when sleeping on their backs, resulting in abnormalities. It isn’t harmful to the baby’s brain, but it can cause the baby’s exterior to develop abnormally.

If you’re a fan of John Legend and Chrissy Teigen, you’re probably aware with helmet therapy because their son Miles has been wearing one for the past year. According to John Hopkins Medicine, cranial remolding helmets are uniquely developed to aid in a child’s cranial development because they employ a hard outer shell with an internal foam lining that supports growth of the flatter parts. They will not harm your child as they correct, however they may not enjoy wearing the helmet for the requisite 23 hours every day for the treatment to function. It’s a quick and easy fix, and most newborns will only need to wear a helmet for three months.

Are cranial helmets covered by insurance?

Cranial helmets are classified as “Durable Medical Equipment” and are therefore fully covered by insurance. Before covering a helmet, your insurance provider will usually want to make sure it is medically required. This used to mean that your child only needed a pediatrician’s prescription to get their device covered. Insurance companies, on the other hand, now require more information than ever before to ensure that medical devices are not given unnecessarily. It’s critical to demonstrate medical necessity, which is where the experts come in.

How much does it cost for a baby helmet?

The first randomized trial of the helmets was published in the journal BMJ on Thursday. According to Brent R. Collett, an investigator at Seattle Children’s Research Institute and author of an accompanying editorial, the authors observed “absolutely no therapy effect.”

Face asymmetry may accompany skull flatness at the back of the head; one ear may be somewhat farther back than the other, and the side of the head may flatten. Helmets had previously been proven to help correct head shape in less thorough trials.

The helmets are sometimes decorated with stickers and painted to resemble a pilot’s helmet or a favorite football team’s logo. Dr. Mark R. Proctor, an associate professor of neurosurgery at Boston Children’s Hospital, said of the new study, “I was extremely startled with the results,” adding that it was “rigorous.”

The study does not rule out the possibility that the helmets could be effective for infants with severe skull flatness and tight neck muscles, which make it difficult for infants to swivel their heads and keep them in one position.

Renske M. van Wijk and colleagues at the University of Twente in the Netherlands put 42 babies with malformed skulls, aged 5 to 6 months, in a custom-designed helmet that permits flattened portions of the infant’s skull to round out as the skull expands.

For around six months, parents were told to have their children wear the helmets for 23 hours a day. Another 42 kids with abnormalities comparable to theirs were left untreated. Infants with the most severe abnormalities were not allowed to participate.

After two years, a researcher who had no idea which newborns had worn helmets assessed the infants’ skull shape. The improvements were not statistically different between the infants who wore helmets and those who did not.

“There are definitely cases of infants with mild to moderate skull deformities who are treated with helmet therapy, and this study confirms and reaffirms that this is not necessary,” said Dr. James J. Laughlin, one of the authors of the American Academy of Pediatrics’ (AAP) policy statement on skull deformities.

The cost of a helmet to rehabilitate flattened skulls ranges from $1,300 to $3,000, and parents are advised to make sure their children wear them all the time. The report gives pediatricians and worried parents “reassurance that not doing helmet therapy will give you the same results as doing helmet therapy, which is expensive” and “stressful for the family,” according to Dr. Laughlin.

Custom helmet designers questioned the study’s findings. A spokesman for Cranial Technologies, Tim Littlefield, described it as “inherently faulty.” Nearly three-quarters of parents whose children received helmets in the trial complained that the helmets shifted or rotated on their infants’ heads, according to William Gustavson, a spokesman for Orthomerica.

“The quality of the fit is completely dependent on the value of this study,” said James Campbell, vice president of the American Orthotic and Prosthetic Association, a trade group.

Some surgeons were concerned that the findings would be applied too broadly, compromising insurance coverage for seriously ill children who would benefit from helmets.

“What I fear is that children with severe deformities may be denied helmets based on this research,” said Dr. Alex A. Kane, director of pediatric and craniofacial surgery at UT Southwestern and Children’s Medical Center in Dallas.

Courtney Reissig, a stay-at-home mother in Little Rock, Ark., doesn’t regret her son Luke wearing a helmet for eight months. His neck muscles were so tense that he preferred to sleep on his left side, which Mrs. Reissig described as “looking like the side of a toaster — flat, not round.”

He outgrew his first helmet, which cost $1,300, and needed a replacement, according to her. Wearing a helmet, though, helped him round out his head, and he now looks a lot like his twin, Zach. “I think the helmets were well worth it,” she added.

Only roughly a quarter of the babies in the BMJ study recovered completely by the age of two.

“This is an issue we created,” stated Boston Children’s Hospital’s Dr. Proctor. “All parents are taught to put their children to bed on their backs. They are not informed about flat heads or how to avoid them.”

Before adopting a helmet, several pediatricians and specialists urge parents to try adjusting an infant’s head.

Once the newborn is asleep on the back, repositioning requires switching which side the infant’s head turns. As a result, pressure isn’t always applied directly to the back of the skull.

Infants with torticollis, or rigid neck muscles, have a harder time repositioning. According to Dr. Chad A. Perlyn, a craniofacial and pediatric plastic surgeon at Miami Children’s Hospital, they may benefit from physical therapy.

In addition to repositioning, he recommends that parents try more tummy time and restrict the amount of time their children spend in car seats. Use a baby carrier, he said, because “there is no deforming force on the skull when the infant is awake.”

Some helmet manufacturers, according to doctors, urge parents to diagnose flattened skulls without consulting a doctor. It’s critical for a doctor to rule out craniosynostosis, or premature bone fusion, as a cause, they said. Surgery is required for the extremely rarer condition.

Assessment tools on the websites of certain helmet manufacturers enable parents to compare their child’s head shape to photographs.

Children with and without a history of positional skull deformation had different head shapes at 36 months. Matthew L. Speltz, Brent R. Collett, Brian G. Leroux, Erin R. Wallace, Emily Gallagher, Jason Shao 204-213 in Journal of Neurosurgery: Pediatrics, Vol. 21 / No. 3 (March 2018).

Are baby helmets medically necessary?

Helmet therapy for plagiocephaly is always an option, never a need. It can be useful under the correct circumstances, but it isn’t always required. With or without the use of a helmet, the head shape generally improves.

Helmet therapy is a decision made by some parents in collaboration with their child’s doctor to try to change the shape of their child’s head cosmetically.

You can discuss your baby’s individual case and the benefits and drawbacks of helmet therapy with your pediatrician or a pediatric neurosurgeon.

Does insurance cover cranial band?

It’s possible that you’ll have trouble getting your insurance company to pay. This therapy would never be considered cosmetic by you or your doctor. However, the long-term consequences of these illnesses are unknown. Although some insurance companies may cover the entire cost of cranial helmets and bands, others will just cover the cost of cosmetic devices, leaving the patient to foot the price. If at all feasible, you, the parent, should be aware of the total costs associated with this therapy before commencing it. Is a plagiocephaly helmet covered by Medicare? Is my insurance going to cover half of the cost? These are some excellent questions to ponder before beginning helmet therapy. However, research has revealed that this therapy’s treatment window is rather short. In this article, we’ll look at the various payment choices, starting with insurance. Care Credit, government grants, GoFundMe, broadcast or internet marketing, and even private charity donations are all available.

How can I prevent my baby from wearing a helmet?

Consider the following suggestions:

  • Tummy time is a good thing to do. Allow your infant to lie on his tummy for extended periods of time while awake during the day.

How long does a baby need a helmet?

How long will my child be wearing his or her helmet? The average duration of therapy with a helmet is three months, however this can vary depending on your child’s age and the severity of the condition. To guarantee that the skull is reforming properly, careful and frequent monitoring is essential.

Does the DOC band really work?

The DOC Band is a successful Plagiocephaly treatment for babies aged three to eighteen months. Starting treatment early has been demonstrated to minimize overall treatment time because the DOC Band relies on normal brain growth, which is high during the first 6 months of infancy, steady from 6 to 18 months, and then slows through 24 months. The length of treatment will be determined by your baby’s age and the severity of his or her disease. Starting therapy between the ages of 4 and 6 months, when the head is growing rapidly, has been proven to shorten treatment duration, while considerable progress can be accomplished utilizing the band between the ages of 3 and 18 months. The majority of treatments last between 5 and 4 months. Although I have seen newborns who require more time in the band and still have fantastic outcomes. I hope this information is useful to you, and I wish you and your child the best of success.

Do Flathead helmets work?

(HealthDay News) — FRIDAY, MAY 2, 2014 (HealthDay News) — A new study reveals that special helmets are useless in treating a flat area on a baby’s head caused by resting in the same posture for lengthy periods of time.

Experts estimate that one out of every five babies under the age of six months has this condition. It’s grown more prevalent as a result of efforts advising parents to put their kids to sleep on their backs to lessen the risk of SIDS (sudden infant death syndrome) (SIDS).

The use of these pricey helmets to treat flattened skulls is contentious, according to the study’s authors, and there has been little research into their effectiveness.

84 newborns with moderate to severe flattening of the skull were studied by researchers in the Netherlands. Half of the newborns wore a custom-made, rigid, snugly fitting helmet for 23 hours a day for six months, starting when they were six months old. The others were not treated in any way.

According to a journal news release, there was no significant difference in the degree of improvement in head shape between the two groups by the time the children were two years old, nor in the number of them who made a full recovery to normal head shape — 25.6 percent of those who wore helmets and 22.5 percent of those who did not.

Skin irritation (96 percent), an unpleasant odor (76 percent), perspiration (71 percent), and pain were all reported by parents of babies who wore helmets (33 percent). In addition, 77% of parents claimed the helmet made it difficult to cuddle their child.

When their children reached the age of two, parents in both groups said they were happy with the form of their child’s head. The average satisfaction score among parents whose newborns wore helmets was 4.6 out of 5, while the score among those whose babies had not received the treatment was 4.4 out of 5, according to the study.

“We discourage the use of a helmet as a standard treatment for healthy infants with moderate to severe skull deformation based on the effectiveness of helmet therapy, as well as the high prevalence of side effects and high costs,” concluded researcher Renske van Wijk of the University of Twente in Enschede and colleagues.

The vast majority of these situations, according to the American Academy of Pediatrics, can be addressed with physical therapy and noninvasive techniques.

Can flat head be corrected without helmet?

Milder plagiocephaly can be repaired without the need of a helmet in 77 percent of instances using a technique called as repositioning. The head can typically be restored to within the ‘normal’ range before the bones in the skull harden and the infant begins to move around more independently if the deformity is moderate and repositioning begins early.

As a result, many parents prefer not to use a helmet to cure plagiocephaly and instead reposition their child’s head until it returns to a normal shape. However, even when the deformity is moderate or severe, some parents choose not to pursue helmet therapy. This could be for a variety of reasons:

  • Some people aren’t even aware that this choice exists, or they don’t learn about it until it’s too late. Because referrals to paediatric experts, neurosurgeons, and other specialists take time, many parents are uninformed of the severity of their children’s malformations or the treatment choices available until after a vital period in their development has passed.
  • Many people are unwilling to treat an illness that is viewed as aesthetic rather than medical. This frequently follows advice from their health-care providers, giving many parents the uneasy impression that they are being vain by subjecting their children to unnecessary treatment.
  • Many parents are taught to assume that their child’s head shape would improve on its own. On the contrary, according to a research released last year, “Only moderate instances can be adequately managed by conservative care, i.e., without the use of a helmet.”
  • The cost of plagiocephaly helmets, as well as a lack of funding, might be a concern for many parents. The NHS only provides funding in extreme circumstances, and the bulk of private health insurance follow suit. Treatment costs, on the other hand, have remained consistent and are comparable to many dental and orthodontic treatments, and a few charities, such as Tree of Hope and Headstart4Babies, often assist with fundraising.
  • Some parents are put off by some clinics’ forceful sales practices and the fear of being taken advantage of. One mother claimed that the practitioner she saw gave off the impression of being a doctor “Her faith in the profession as a whole was shattered when she was labeled a “charlatan salesman.”
  • Others are concerned about the possible discomfort associated with wearing a plagiocephaly helmet. However, this is an uncommon occurrence that usually occurs when therapy protocols are not followed appropriately.
  • Following the recent media attention on plagiocephaly helmets, some parents believe that the correction they provide is no better than what may be accomplished through repositioning. The great majority of earlier and subsequent research has rejected this claim. A visible, permanent repair can invariably be obtained if treatment is initiated within the first 14 months and the necessary protocols are followed.

We hope that this post has highlighted some of the points that you might want to think about when deciding whether to treat your child’s plagiocephaly without a helmet or with a helmet. If you’re still undecided, there’s a wealth of information available online, including study papers, parenting websites, blogs, and more.

Can you correct a flat head at 4 months?

When their child need a helmet, many parents begin to blame themselves. You could even wonder if those annoying flat spots, often known as plagiocephaly, could have been prevented. The truth is that most babies’ heads aren’t properly shaped. Most adults, in reality, do not have perfectly formed heads. Small bumps and flat patches are common. When your baby’s skull has a wide flat patch on it, it’s usually due to delivery — your baby’s skull may have become irregularly shaped when passing through the birth canal — or because they rest flat on their back on a regular basis.

The skull bones of an infant’s skull are flexible, which means they move more easily than they do in an adult’s skull. This allows your baby’s head to pass through the birth canal and their brain to develop during childhood. Constant pressure on the back or side of the head, on the other hand, can result in irreversible deformity if not rectified.

When does my baby need a helmet?

Your baby’s head shape is unlikely to cause brain damage or other developmental concerns. In reality, most insurance companies and doctors regard a flat area as a cosmetic issue. So, how can you know if your child requires a helmet?

At each well-child appointment, your doctor will examine your baby’s head size and shape. During infancy, these visits occur every two months or so. Your doctor may recommend a helmet if your kid has a large flat spot that isn’t improving by the time he or she is four months old. Treatment should begin between the ages of 4 and 6 months for a helmet to be effective. As your child grows, the helmet will gently sculpt his or her head. Because the skull has begun to fuse together, treatment is generally regarded unsuccessful beyond the age of one.

What does wearing a helmet involve?

The use of a helmet to correct positional plagiocephaly is not for the faint of heart. During treatment, you must keep the helmet on your infant for 23 hours every day. Helmets are typically worn for several months. To keep up with their growth and changing head shape, your child’s helmet will need to be adjusted on a frequent basis, perhaps weekly. It can be costly to purchase and modify a helmet on a regular basis because insurance does not always cover it.

Other treatment options for positional plagiocephaly

Simple repositioning strategies have been demonstrated to be just as effective as wearing a molded helmet in several studies. Your doctor may also recommend physical or occupational therapy to address any other issues, such as infant torticollis, which is characterized by a twisted neck. These approaches can assist you in repositioning your infant and allowing their skull to repair flat regions on its own:

  • Make time for your stomach a priority. Every day, place your infant on his tummy under supervision. This relieves pressure on the back of your child’s head and helps him build his neck muscles.
  • Cuddle. Holding your infant isn’t just a terrific way to bond with your child. It also relieves strain on your child’s back that occurs naturally when he or she sits in a car seat, swing, or carrier.
  • Switch things up a little. Try positioning your baby in such a manner that he is forced to turn away from the flat region on his head. Both sides should be breastfed. Place him in his crib in various positions so that he must turn to view you. You can also move his crib every now and then so that no one region on his head becomes overused or flattened.

In the majority of cases, your baby’s head shape will correct itself. As they begin to move and accomplish more, your baby’s head will develop and return to normal with time and effort. Wearing a helmet to address major malformations or flat patches on your baby’s head is also a smart idea. Inquire with your doctor about whether your child requires a helmet and what you can do to help him correct his flat spot.