SPARC Forums

I just got a bill from my son's Ear Nose and Throat doctor for $250 something. He is on Medicaid. For some reason, Medicaid wouldn't pay for his ear tube removal. Any ideas as to why they will pay to have them put in, but not pay to have them removed? FWIW, we had to have the ear tubes taken out and are getting new ones put in. That is according to what my son told me. My ex won't talk to me about any of this. I thought the tubes just fell out and we are having new ones put in on the 17th because he still needs them. Why would you need to pay for tubes to get removed anyway. Don't they fall out on their own after a while? I will talk to the doctor at my son's appointment on Monday about this stuff, but thought I would see if you all had any ideas to share. Thanks. This is my first time dealing with ear tubes.

Always remember this:  Medicaid is like the family court system....there's often NO logic for why they do what they do.  It reminds me of a state medical program we have here...they will pay to have all your teeth removed, but they will NOT cover the cost of dentures.  Makes absolutely no sense whatsoever.

Sometimes tubes will fall out and sometimes they will stay.  Everyone is different.  But even if I was an MD (which I'm not), I would still only be able to explain in generality.  Since no two people are alike, that means no two people will respond exactly the same in a specific medical situation.  The only way you can get any definitive answers is to talk to the state Medicaid office (regarding what they will and won't cover) and your son's doctor (regarding the ear tubes).