It is my understanding that the parents should not have to be burdened w/ any expenses. EI's guidelines require that they must utilize the child's health insurance first, but you can get them to cover the co-pays. All you need to do is to tell them that it is a financial burden on you and your family. EI will cover it. If they don't then you just need to go up the chain of command...basically be a thorn in their butt until you get it because you should not have to pay a dime (unless you are getting services that is not covered by EI).
If you do not have insurance, EI is suppose to pick up the expense.
We can not afford much of the services either. We have been utlizing all resources in the community that offer free services, such as music therapy and occupational therapy. There are waiting lists, but some is better than none. Like the previous poster said, you take advantage of your time with the therapists and learn as much as you possibly can because the services through EI are much better than what the child may recieve in the school system (of course this will vary from state to state). My state doesn't cover ABA like the others mentioned.
Also, see if you can find a program in your state or county that may offer financial assistance w/ the therapy expenses.
My ds will be attending the Early Intervention program in our county this fall. I have an appointment with their counselor in a couple weeks to see exactly what services my son needs but I do know for sure he will need speech therapy. Our insurance does not cover any therapies for developmental delays (which really sucks since we pay so freakin' much for health insurance). I noticed that many of you have your children in so many therapies and I was wondering how you obtained these services. Are Early Intervention programs within the school district really helpful? Will he get one-on-one treatment with a speech therapist at the school? What if we can't afford to put him in private therapies? My husband makes decent money but we happen to live in a part of Michigan where the cost of living is so high we don't have any extra money. We were thinking of moving to Toledo which is only 20 minutes South of us because once we cross the state line we stop paying for Detroit. But I've read that some of you think Ohio is not good at providing services for kids with ASD. I guess if we move we will have more $$ to pay for additional services....I just don't know what to do or where to start. I'm sure the school counselor will be helpful when I meet with him but I'm getting impatient and feel like I should be doing something now. My ds is stimming like crazy and started hand flapping yesterday. It looks quite odd - like is hand is made of rubber.
Stephanie,
Hi. Could help but notice that you live in Michigan. I grew up in the Detroit Metropolitan area. I haven't live there as an adult though. Anyway......I don't know about Michigan unfortunatey...but most states the services for early intervention are free. I have heard some people in some states say that they have to pay a portion of therapy in early intervention depending on your income...I hope that Michigan is not one of those states. I live in the south and my husband is military and in 3 different southern states that I have lived in offered free early intervention regardless of income. My son got 1 hour speech a week, 1 hour of OT a week, and 1 hour of a PT like therapy a week. Also in Kentucky they offered (because i lived on post) daycare for social. When you meet with the early interventionist I would ask what all is available and whether you will have to pay for any services. Also..you said that your insurance company doesn't cover any of these therapies. You may want to call them back and ask if they have a sub type program that you would pay into that would provide these therapies. I realize that means a higher monthly premiums but it will still be less than paying up front for all these therapies. Also like michelle said...check on medicaid for your state. You may qualify regardless of income because of the diagnosis that your child has. I wish I could help you more here. Take care and keep us posted.
Karrie
Hey Stephanie. Early Intervention can be wonderful. Each state has its own services they offer. Once he turns 3 he should be aligable for special ed preschool and thats usually a big help too (provided you have people who actually care and arent just doing a job involved). Early Intervention for us was an hour a week of 1 on 1 ST OT PT Behavior therapy. I learned so much watching them with him that I countinued the same type of play, interactions, and talking as they did. and Early Intervention and special ed preschool should be free.
Its sad that all our kids can't be treated equal,... that one state approves and pays for ABA and other states dont.... that some kids get private ST, OT, PT and others cant.... that some special ed preschool programs are all day 5 days a week, and others are 2 1/2 hrs a day 4 days a week. Its sad that unless we have money we can't get our kids services they NEED.
There is also transitional and medicaid waivers that SOME will help pay for additional therapies for a disabled child, heres a link for Michigan and other State Specific Resources and a link for
LISTING OF MEDICAID, MR/DD, DEEMING WAIVER, TEFRA & OTHER ASSISTANCE PROGRAMS http://www.geocities.com/HotSprings/Villa/1029/medicaid.html
I too unfortunately cannot afford more than the state provides for free...but the preschool program was an INCREDIBLE help for my son. ST 1.5 hrs/week and OT 1 hr/wk. But basically, the whole class was 'therapy' of sorts. He made leaps and bounds there...and Michelle had GREAT GREAT advice...just watch what they do...it's true...a lot of things you can carry over into your home and do yourself. The best advice I can give is communicate a lot with whoever is teaching your child. I know they like when the parents are involved...and communicating can help you maintain consistency as well as work on specific issues that come up if you have that line open with them.
GOOD LUCK!
~Lesley
I also ran into the same problem. I called 3 therapy centers to get my son enrolled in OT and ST. The first one that called back said that I had to pay cash up front and that insurance would not cover because they don't cover developemental delay's ( I gave them my insurance info so they could check it out). Another one said the same thing. The last one that called me back talked to me for about 1/2 hr and said that coverage would be no problem. Infact I had incredible insurance and should only have to pay out of pocket 500.00 for the whole year (instead of ,000). I did not believe her.
She explained to me that when they file insurance claims for developementaly delay kids they find a "medically cureable condition" they can file under... not developemental delay (they never ever lie they just make a point of finding a mecially treatable condition, that he has, that can get coverage). Most insurances do not cover developemental delay's . So when they noticed my son drooled they filed under drooling dysfunctions... which got him speech coverage. Most insurances will also cover apraxia/dyspraxia which will get you occupational therapy coverage and speech coverage. The Therapy center that you go to has to be smart how they file their paper work. You may have to call a few centers but just keep calling.
She also gave me another tip. Never ever let your peditrican or school diaganose your child with autism or develpemental delay... god forbid the insurance company gets ahold of that and start denying your claims (because they can access doctor records and school records). Sensory intergration is a safe diaganosis that doesn't throw up too may red flags. I even expained this very bluntly to the peditrican and the school. The peditrican said no problem as long as my son is getting covered and it is helping, he didn't care. The school has not cared for the last 6 years...but this year they really pushed for me to change is diagnoses but I declined. I told them to call the therapy center and listen to the potential problem with insurance coverage. The head of the Special ed department for our county was amazed first... that my son is still getting full coverage for OT and ST (he is 9 yrs old). Second... That insurance companies could ask for school records and then deny a claim if I don't let them see the school records. So that is why I won't let them change is school diagnosis to anything but Speech apraxia/Dyspraxia. I protect our insurance coverage at all costs.
This therapy center has insurance coverage wizards there.
Hope this info helps a little.
[QUOTE=Jenny P]
She also gave me another tip. Never ever let your peditrican or school diaganose your child with autism or develpemental delay... god forbid the insurance company gets ahold of that and start denying your claims (because they can access doctor records and school records). Sensory intergration is a safe diaganosis that doesn't throw up too may red flags. I even expained this very bluntly to the peditrican and the school. The peditrican said no problem as long as my son is getting covered and it is helping, he didn't care. The school has not cared for the last 6 years...but this year they really pushed for me to change is diagnoses but I declined. I told them to call the therapy center and listen to the potential problem with insurance coverage. The head of the Special ed department for our county was amazed first... that my son is still getting full coverage for OT and ST (he is 9 yrs old). Second... That insurance companies could ask for school records and then deny a claim if I don't let them see the school records. So that is why I won't let them change is school diagnosis to anything but Speech apraxia/Dyspraxia. I protect our insurance coverage at all costs.
[/QUOTE]
Thanks for that info...very interesting. I think the bold part we all have to really think long and hard on depending on where we feel our child falls on the spectrum. I can understand your POV about not wanting a child to be classified as Autistic or having a developmental delay, but parents must must really research as to what the actual diagnosis will do in terms of the services and benefits offered to their child. My insurance covers developmental delays, but only offers a certain number of sessions per year (ie 1 OT per week and 1 ST per week). Sometimes if a child is diagnoses as autistic, they would be able to get services (for free) that they wouldn't otherwise get from the state and/ or federal governments or other charitable organizations. For instance, a state may or may not offer speech therapy to ASD or developmentally delayed kids but will provide ST services through the school if the child is DX as having Autism (mandated by state law). So it is extremely important to research, research and research before you decide how to proceed with evaluations and treatments for your child.
In my case ds has always been on medicaid. Where I live, even though we make enough to pay for our bills and our mortgage and whatnot, we are still considered low income because income is just not very high here on average. So luckily, everything is covered w/ ds. And our Birth to Three is free anyway so his ST is free. I don't know about the other services because ds isn't using them yet. I guess I will find out more if he is dx'd in Sept.
Amber
Jenni
You have a great point about making sure parents "research as to what the actual diagnosis will do in terms of the services and benefits offered to their child". In our case the private OT and ST is a lot more helpful and has made a lot more progress than the school district services (and we have a GREAT school district and a Awesome Special Ed Program) The school district does offer Speech and OT (and other special classes for autistic kids) but it is for only a few minutes a day with the whole class and once a week he gets pulled out of class for 15 minutes of individual ST & OT .
Everyone needs to weight the benefits for themselves and their situation.