$50,000 later…
$50,000!!! 20,000 to Children’s IBI Center for ABA therapy + $20,000 to aides for ABA therapy + $5,000 for speech therapy + $5,000 for occupational therapy. There is a quick $50,000 we’ll spend this next year on autism. We haven’t considered any materials bought yet, paying for preschool, any groups we decide to try, possible music therapy, etc. And even more, we haven’t even MENTIONED biomed yet! That’s because we have no idea what to budget there since we are only a couple months into this and are still figuring out our future in biomed and what our insurance will cover. Now, obviously this won’t all be coming out of pocket…our pockets aren’t that deep, they are pretty empty since we had to fund a lot of this on our own last year. I haven’t a clue how families are getting by spending this kind of money…I am SO thankful we have our waiver and the autism scholarship to help us out.
Why am I bringing this up now? A couple reasons. The first of which is the insurance bill out there right now. I won’t pretend to have a clue what it is about really, I haven’t found the time to research this yet. My understanding is that it won’t directly affect our family, because neither our insurance company nor Jerod’s employer are based in Ohio. However, I am in full support of any bill that will get any family any additional funding. If anyone is reading this and has any easy-to-read info on the current bill, please share! If either McCain or Obama are willing to take a step forward in funding therapy for families with autism, whether ABA or biomed (hopefully both), they will have my vote!
Another reason I am mentioned the sore topic of money right now is some recent discoveries about our insurance coverage. We have been running Brady’s ABA program for nearly 11 months now, and just found out our insurance company is a bit behind on paying the bills…and by a bit…I mean they have never paid a penny! That’s right, Children’s has never gotten any payments from them, and now they are claiming Children’s is out-of-network. For a million reasons (which I won’t mention here since the situation is being resolved), we weren’t aware of this…and after a few days of worry, sleepless nights and considerations of whether or not we can continue…we are more thankful than ever for our Medicaid waiver! We would not be able to afford one more week of Brady’s therapy program we do with Children’s if it weren’t for our waiver. We are working hard to appeal to our insurance company to try to get them to cover it, but I am skeptical as to how much luck we will have. Although they cover most of the therapy codes we are using, they say we have to use someone in network…which only includes 2 child psychologists anywhere near us…both of whom specialize in medication management (not necessarily autism)…and neither of whom specialize in ABA. They are still denying claims for 6 months of speech therapy that I called and got preapproval for due to his diagnosis…so we will see how much success we have this time around. Oddly, we have had some pretty good success so far getting reimbursed for biomed appointments and testing. But of course, Dr. DeMio codes all of this as leaky gut and metal toxicity…so the word autism isn’t even mentioned.
So, the long and short of it s this…know who is paying for the therapies you are doing, how they are being billed, etc…you never know what may fall back to you. And if anyone can share info about insurance coverage and the bill out there right now, PLEASE DO!!! I am clueless to what is going on there, as a Mommy still trying to figure things out for her own son, I just don’t have the time to look all this up myself. But I would be very interested to read what others have found out. It saddens me every day how much time I must spend doing paperwork, making phone calls and researching to try to get all of this hopefully paid for by different sources…that is all time I am losing with my beautiful little boys.
