she is an older lady, i can tell.
DH is in the Navy, deployed off of iraq right now. we're stationed at NS Mayport
What do you do when you can't afford to pay your ins. deductables and can't get any govt. help. We both can't get individual ins. either. We can't get anything. Some therapies centers here take no ins.I bet its the same lady. Yes I always have to leave messages, she is very good about calling back. Older lady, you can just tell. I can't remember her name though, but I like her a lot. Glad you have a good PCM, I think that is the key. Make sure something somewhere says she isn't potty trained and self help skills are way below age level in that paperwork. I read somewhere (another post by a military person) that they will almost never turn you down for echo if the child is still not potty trained and self help skills are way below age level. Good luck and keep us posted!
Is DH in the Army? We're in the Air Force, stationed at MacDill in Tampa.
thank you all for the advice.
linda, that is such valuable information. i. acutally in fl too (jax mayport) and called tricare (well, echo program) yesterday. i left a voice mail with someone and will probably call back today. i have a great relationship with her pcm and im sure she'd give a great write up. kylie isnt potty trained, nowhere near it. so far below self-help skills.
the speech im not worried about. she gets that twice a week (private) along with ot and pt. that until she starts school. tyhank you so much!!!
do you know if these services are nomally covered by med insurance? we're military so we have pretty good insurance, but the pay isnt good. we really cant afford anything at all unless its covered. i shouldve probably mentioned that....i hope this doesnt limit us to her treatment options...I'm not sure what services are covered by medical insurance. Policies vary so much. But I would assume that any DAN consultations and treatments would not be covered, since it's outside of mainstream medicine.
You didn't say how old your daughter is. If she's under 3, she may qualify for Early Intervention through the state. If she's over 3, she may qualify for special ed preschool through the local school district. These services are FREE. One way to find the EI contact for your state is to look at the Nichcy list under "State Agencies and Organizations." The Nichcy link is listed below, along with another expert-find service that I forgot to mention in my last post. Again, good luck with everything.
Various: Also organized by state
NICHCY compiles disability-related resources in each state, and creates State Resource Sheets. This handy resource sheet will help you locate organizations and agencies within your state that address disability-related issues, including:
State agencies serving children and youth with disabilities
State chapters of disability organizations and parent groups
Parent training and information projects
http://www.nichcy.org/states.htm
Various - Alphabetical lists organized by state
Through Wright's Law's "Yellow Pages for Kids," you can find educational consultants, psychologists, educational diagnosticians, health care providers, academic therapists, tutors, speech language therapists, occupational therapists, coaches, advocates, and attorneys for children with disabilities on the Yellow Pages for Kids for your state.
You will also find special education schools, learning centers, treatment programs, parent groups, respite care, community centers, grassroots organizations, and government programs for children with disabilities.
http://www.yellowpagesforkids.com/
darn.
she is 3 and is currently going thru what our state calls childfind to get her into the school system. thanks for all the info. :-)
hi all.
we're in the military and have really gotten no where in terms of dr's and therapies and i dont know where to start.
i'd love to get her started with some ABA and some kind of social therapy. and poossilby see a DAN doc or behavioral specialist. dont know where to go....PLEASE HELP....
THANKS,
DEE
Welcome to the forum. It's not easy to know which expert to trust and which therapy to choose, but one place to start might be to find out what kind of services are available in your area. You can contact your local Autism Society of America chapter, or you can search for experts yourself. Here are sources for tracking down ASA chapters and all kinds of different experts (please ignore the yellow highlighting). Good luck.Various:
Below is a link to the database at the Autism Society of America, the most comprehensive of its kind. You can do a search by word or by the following categories: ASA Chapters, Assistive Technology, Camps and Recreation, Consultants, Community Supports for Adults, Crime Victime Services, Dentists, Early Intervention, Government Agencies, Information and Support, Legal/Advocacy, Medical and Diagnostic, Physicians, Private/Non-Public Schools, Psychologists, Public School Systems, Related Services, Research, Respite Services, Service Providers and, last but not least, Training.
Certified Behavior Analyst:
http://www.bacb.com/consum_frame.html - click on "Certificant Registry"
Speech therapist:
Have you signed up for the EFMP (exceptional family member program) yet?
Once you qualify for that, there is ECHO, which can help pay for some ABA, as long as you are active duty. There are rules to who can provide the ABA, and of course how many hrs will be paid, but you should have access to a case manager that should be able to provide all the info.
If you have questions on these programs, and how to get started, talk to your PCP, they should have all that info readily available. There's also lots of info available on the web.
We've never seen a DAN dr., but many of them will not take any insurance.
Good luck.
here is a list of DAN doctors--scroll down to find your state. Our ins reimburses 60 percent of the visits.
http://www.autismwebsite.com/practitioners/danus.html
Hi,
My son have 2 1/2 and we live in military housing, we are under the EFMP program. You can speak with your ombudsman about your situation.
Did anybody know about it's good to my son have a vaccine at this moment?
Please let me know.
tnks!
School therapy was not enough for our son who's language disorder is Severe. Privates said it will take 3 hours a week. Private therapy is way better. Daniel may be turned down for insurance. His dad's group has a 3,000 a person and 9,000 a family deductables. He makes to much for govt. help. Remeember Mom's/dad's there is school education geared St and private St that's geared towards daily life. Ot has 2 types also 1 toward daily life and 1 education geared.I may get turned also.
America is in bad shape both education/ins. wise.
Another option is applying for medicaid and SSI, depending on your DH's rank and if you work. If he is an E5 or below and you don't work you have a good chance of qualifying and they will cover speech with no hoops. Not sure what that would mean for to your tricare, but I do know lots of families with special needs kids have done that. THat may be something to consider.I am not in the military, but wanted to say welcome to the boards and if you can get your hands on a copy of "A Work in Progress" by Ron Leaf and John McEachin, it provides a great overview of how aba works. I've been using it as my guide for the past couple of months and before that I used the techniques that our speech therapist taught me to use (she was using aba but was medically coded as speech therapy for insurance). There are no aba therapist in my area...at least none I can afford. I have become the therapist for my boys. Good luck with tricare and I hope you can get a good aba program in place soon.Look for a dan dr. who also is a md our's is. Ins. then will pay for some of the stuff. [QUOTE=zacsgirl]dd was diagnosed with pdd-nos in march by a dev ped. she is 3 and has been in speech, ot and pt for almost 3 years now. but i was told tricare will stop paying once we finish the childfind process and she gets into school for her therapies.
i did call tricare about echo the day we were diagnosed. but didnt get anywhere.....i dont have an IEP yet. thats where we're at in the childfind process. awaiting our big meeting. they help me make an iep for her, right? i hear thats very difficult.
ok, so call tricare for echo and ask for paperwork and fill that out, asking for aba and attach the write up from the dev ped. how long will it take for us to start her aba?
[/QUOTE]
You've got the hardest part done, you just haven't talked to the right people yet. Technically yes, all tricare therapy stops at age 3 cause then Tricare says it is the schools responsibility. (this does not include the ECHO program and ABA, sadly and suprisingly a lot of tricare and medical personel don't even know what ECHO is. When I called tricare's direct line and asked about it they thought I was talking about a cardiology exam!
Go to this site and find the number for your region (at the bottom of the page) and calll them, this is the ECHO representative for your region. This site also has good Echo info: http://www.military.com/benefits/tricare/tricare-extended-ca re-health-option
Then tell them that she just turned 3, you do not have an IEP yet and not sure when that process will be done, but you do have a diagnosis of PDD-NOS and you want to start ABA and if they could send you out the paper work and help you with that. the person you talk to will most likely be the person assigned to you. I was lucky and got a good one (we're in Florida) and she walked me through it. She should tell you what to do. I don't know your daughters issues, but the boys were diagnosed as autism spectrum disorder and they are not potty trained yet and they are way behind in self help skills. All of that helped get it approved. You will have to take the paper work in to the PCM there is a part he has to fill out. I don't know what relationship you have with your PCM, mine knows the boys very well and I drop off copies of all evals so I just dropped it off and he wrote on there that the boys would benefit from ABA therapy and why. Then I picked it up and sent it off to the address they gave me. She called me like a week later that it was approved, gave me a list of companies to call and told me to pick one and call her back and she would issue the referal. So that's what I did. A week later i had my referal letter and they started the ABA.
speech especially is trickier. Tricare says its a learning disability and unless it is medical they will not cover it, its the school's responsibility. Really they are right, but some schools speech therapy is a total joke. But because of the medical thing it is easier to get PT and OT through them than speech once you hit 3. While we were in DC and the boys turned 3 the school refused to give them anything but one hour of speech a week, they were nonverbal and I did not understand why they didn't give them OT cause they couldn't even feed themselves or drink from a cup. They also said they had no sensory issues and they had a whole list from early intervention. I should have gone through mediation but I knew we were getting orders. The one hour of speech turned into one hour a month. I was told there was nothing I could do. We moved to Florida and they got 90 min of speech a week in their IEP, which really meant 30 if the speech path showed up. They went from 50% delayed at age 3 to 75% delayed at age 4 according to the school speech path's eval. So I took a copy of that and a letter their psych wrote to their PCM saying that he felt the boys were autistic (I did not have a diagnosis yet) and that the school will only provide what is required by law and these boys need much much much more than the bare minimum so please put in a medical referral for speech and tricare will cover it that way and a referal for OT. I made an appt (the boys needed a well baby anyway) and I went in armed. This is when the PCM sat up and payed attention to me and stopped telling me tricare would not help me and the schools were so great. I think he may have been new to the area when he tried to tell me that. He is completely different now and I know I'm not the only one down here with a ASD kid. So the PCM said OT I can get you easy, I don't know about speech that is trickier. All I can do is put it in with the letter and the proof that they are regressing and see what happens. So I got a one time referal for a private speech path for an eval only. I had to send them a copy of the IEP so they could know what therapies the school was providing. The evaluator at the private place wrote up her eval to say that the school only provided group therapy and her recommendation was 1:1 therapy, the boys were regressing not progressing in the school system, and they needed more hours than what the school was providing. Also the boys were receiving zero OT from the school, it was suppose to be put in place and never was. So I got my speech therapy and they were approved for 50 30minute sessions to expire in Dec each. They got much less of OT, but OT will be much easier to get and to extend. We will try to extend the speech come Dec, I have no idea what will happen. In a nutshell, tricare will provide it if the school isn't able, like if they really need 2 hours a week but the school will only give them 1, they will give them the other hour. This is the part they don't tell you up front.
Essentially you won't be able to do much about OT and speech until you know what the school will provide. Most schools do not provide ABA however. Sorry this turned out so long, but hope it helped.
thank you all SO much!!! she is cat 5 in EFMP. been that way since birth due to the traumatic birth she had. no one EVER told me that would pay for some ABA!!!!
ill email our ombudsman. see what i can do. didntknow that about the 60% with the DAN, docs, either. i feel stupid.
We are in the military too. It has been a fight but the boys are getting ABA, extra speech and OT and all paid for by tricare. THis is in addition to what the school provides. The boys have been EFMPs since birth too, that's half the battle. To get ABA you have to have a diagnosis of autism. Do you have that? Push your PCM for a referal to a developmental pediatrician and or a neurologist. It can't come from a psychologist, it has to be from a med dr or they won't accept it. Once you have your referral call tricare directly and tell them you want to talk to someone about the ECHO program. A lot of the medical facilites don't even know what ECHO is, we're at MacDill and the clinic here had no idea what I was talking about. Tricare will get you in contact with the echo person in your area. Tell them you are awaiting a diagnosis of autism but could they please go ahead and send you the paperwork. Once you have the diagnosis you will take that and the paper work to your PCM. They need to fill out the part that justifies why ECHO is needed. You have to be specific and ask specifically for ABA. I included a copy of their IEP and the write up done by the dev pedi. I have a co pay of 25$ a month, but they are now getting 10 hours a week each and we hope to increase that as the therapist has more time open up. They are also getting speech through tricare which is hard to get but because of the diagnosis and because the speech path recommended more hours than the school will provide they are getting it. I just went back and read that she is 3 and they are trying to place her within the school system. If you have any questions about the whole process and the military feel free to PM me. I've been going through all of this for a while now and pretty much know the process.Also just to let you know, Tricare will only pay for a certified BCBA for the ABA therapy. Often the BCBA doesn't want to do the actual therapy, they just want to run the show and then you would have to pay for the actual therapists out of pocket. I found a guy here though that is a BCBA but does all the therapy himself. He mainly works with military people because honestly no one else can afford what he charges. Its going to depend on where you are and if you can get a BCBA to do the actual therapy. Tricare will give you a list once you are approved and have you call them to see if they have any openings before they give you a referal to an actual dr. Make sure you ask them if the BCBA will be doing all the therapy, they should know tricare will only cover the BCBA, but cover yourself and make sure you aren't going to get any unexpected bills. Call your PCM immediately and make an appt to talk about this and get your referal, dev pedis depending on where you are can have long waiting lists. Getting ABA in place might take some time, so you want to get your name on any lists for dev pedis that might be as soon as you can. Of course this assuming you don't have a diagnosis of autism. If you have one then you can have it all in place in a couple of months. Also if you have a good PCM that is willing to help you (it took 4 years for me to finally get one) things will be so much easier for you. Don't hesitate to change PCMS if you need to to get one that will listen to you and help you. The boys haven't had the diagnosis very long so all the additional therapies are new, but the difference it has made has been incredible. So don't give up fighting!
Also to add, I don't think tricare will cover DAN, our PCM did check for lead and other blood tests. You can call tricare and ask, but it might be considered alternative and therefore I don't know that they will cover it.
dd was diagnosed with pdd-nos in march by a dev ped. she is 3 and has been in speech, ot and pt for almost 3 years now. but i was told tricare will stop paying once we finish the childfind process and she gets into school for her therapies.
i did call tricare about echo the day we were diagnosed. but didnt get anywhere.....i dont have an IEP yet. thats where we're at in the childfind process. awaiting our big meeting. they help me make an iep for her, right? i hear thats very difficult.
ok, so call tricare for echo and ask for paperwork and fill that out, asking for aba and attach the write up from the dev ped. how long will it take for us to start her aba?