Special Needs Safety Bed Insurance Denial

If your loved one or child could benefit from a special needs safety bed, having that safety bed denied by insurance can be devastating. Getting good quality sleep every night is vital for good health, especially for children. A child who could wander at night or has a hard time settling down to sleep can potentially benefit from a safety bed, which may be referred to as an adaptive bed, special needs bed, child-safe bed, or an enclosed canopy bed. 

These beds are frequently used by children with special needs, including cerebral palsy, Down Syndrome, Angelman syndrome, autism spectrum disorder, cognitive delays, or those with developmental disabilities. Children with ADHD or other hyperactive behaviors can also have a challenging time winding down to sleep and could benefit from a special needs safety bed. 

A parent who is worried and exhausted from a child who does not sleep or wanders at night may see a doctor’s request for a safety bed as a lifeline. When the insurance company denies a safety bed, it can feel like a betrayal. Attorney Scott Glovsky is ready to advocate on your behalf, seeking justice and a fair decision. 

How Does a Special Needs Safety Bed Work for Autistic Children?

While a safety bed can work well for many different disorders and behaviors, it can be especially effective for children on the autism spectrum by reducing distractions and creating a calm space for sleeping. A safety bed for a child with autism addresses the child’s unique needs and challenges while ensuring safety. These beds may have features like an enclosure that acts as a physical barrier to prevent falls during sleep. 

Some safety beds offer additional features like dimmable lights, adjustable positioning, and noise reduction. These features promote uninterrupted sleep by reducing sensory disturbances while preventing potentially hazardous wandering during the night. Many safety beds incorporate a locking mechanism to prevent the child from leaving the bed without supervision. The tent-style beds create a cozy, relaxing space for the child. Some popular safety bed brands include the Sensory Bed by zPod, the Safety Sleeper Bed Enclosure by Abrams Bed, Cubby Beds, SleepSafe, Freedom, and others.  

Why Would a Safety Bed Be Denied By Insurance? 

A zPod special needs bed costs about $17,000, while a SleepSafe bed costs between $7,000 and $9,000. This is the primary reason an insurer might deny a safety bed. While the insurer may “cloak” the denial behind words like “not medically necessary,” in the end, the denial is likely a result of the cost. In some cases, an insurance denial could result from insufficient information on the claim or errors in the claim. 

If this is the problem, these issues can be easily corrected. Some insurers may specifically exclude certain treatments, while others require pre-authorization. Insurance companies consistently watch the financial bottom line, meaning that more expensive treatments are more likely to be denied.   

What Should You Do for a Special Needs Safety Bed Denied by Insurance?

If you receive a denial of a special needs safety bed claim, it is easy to feel helpless. It is important to know that you do have options. You can file an internal appeal, which asks your insurance company to reconsider its original denial decision. Ask your doctor to write a letter that clearly details how your child will benefit from a special needs safety bed, and include this letter with your internal appeal. If your insurer continues to deny your claim, you can file an external appeal with a neutral third party. Because the decision made in an external appeal is binding on your insurance company, we suggest speaking with an experienced health insurance denial attorney before you file it. The reason is that depending on the type of insurance you have, an attorney may suggest taking legal action instead of filing an external appeal. 

Which Insurance Companies Are More Likely to Deny a Request for a Special Needs Safety Bed?

Although any insurer can deny a claim, some insurers seem more likely to do so than others. If a special needs safety bed is not specifically excluded in your insurance policy, it is time to fight for justice and for what your child needs. 

While insurance claim denial numbers are hard to come by, in 2023, 19 percent of those insured under the Affordable Care Act received a claim denial. Unfortunately, fewer than 1 percent of those denials were appealed, even though appeals result in overturning the denial almost half the time. California insurers who could deny a request for a special needs safety bed include:  

• Anthem Blue Cross
• Blue Shield
• Health Net
• Kaiser
• Cigna
• Aetna
• Medi-Cal Managed Care Plans (Anthem Blue Cross, Promise Health Plan, Health Net, Molina)

How the Law Offices of Scott Glovsky Can Help with a Safety Bed Denied by Insurance

If you are facing a special needs safety bed insurance denial, Attorney Scott Glovsky can help. Scott understands how devastating such a denial can be and is ready to fight for you and your loved ones. Scott offers passion and commitment to every client, and because he started his career by working in large corporate law firms that defend insurance companies, he knows how these companies think and operate. This allows him to stay a step ahead of the legal tactics used to deny claims. Scott and his firm are well-respected and have a solid reputation in the industry. Contact the Law Offices of Scott Glovsky today.