#Autism: Battling the insurance companies

Do you recall how Emmett has been refused speech therapy?  Do you also remember that the reasoning behind was that he hasn’t made enough progress and he’s not expected to catch up?

As if that wasn’t bad enough,  they have now denied him occupational therapy as well.  The reasoning is that it isn’t medically necessary. The justification for that is based on a numbered scale,  where aparantly Emmett tested a few tenths of a point to high and so he no longer needs therapy

You’ll have to excuse my language but that is fucking bullshit. This is like jump into your waders because the shit is getting deep kind of bullshit.

A few tenths of a point? He’s not not expected to achieve? Are you fucking kidding me?

Clearly they are not and so that means that we now have another battle to fight in the war that already rages on multiple fronts.

We are going to go through the proper channels. However,  if the proper channels produce nothing, well,  than I’m going to make this very,  very ugly for them.

Emmett is not the first child with #Autism to be kicked to the curb and abandoned by an insurance company and he very likely won’t be the last. Who holds these companies to any sort of moral or ethical standard?  The answer is no one? These companies answer to the almighty dollar. 

I realize that companies have to draw the line somewhere, however,  who dictates where that line is to be drawn and who in the hell has decided that Emmett will never catch up in the speech and language department?

We aren’t talking unnecessary therapies either.  To a child with #Autism,  speech and language therapies can literally means the difference between remaining silent and learning to speak. How is that not vital?

To a child with #Autism and serious sensory processing issues,  occupational therapy is absolutely essential for learning to cope with or overcoming the sensory obstacles in their way. This allows them to better live in and navigate our extremely unsensory friendly world we live in.

These types of services shouldn’t be a luxury,  they should be each and every child’s right.

As it stands,  there is absolutely no way that we could pay out of pocket for the amount of services Emmett desperately needs each week. Right now,  we are expecting to see physical therapy gone as well. 

I’m one angry papa bear and I will fight to the death for the betterment of my cubs.

**Thanks for reading**

       -Lost and Tired

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Laura4890

Both of my children should have speech therapy abd OT. Cigna insurance has them “in review.” They’ve been “in review” since August. It is complete bullshit. An earlier diagnosis is supposed to be better. I feel like I did the right thing getting my kids evaluated. But an earlier diagnosis certainly isn’t doing anything for us if we can’t get them the help they need. Its completely nuts. We shouldn’t have to fight this hard for much needed treatment.

Megan Kitchen

Have you tried talking to his school about increasing services there? I know my son's school was willing to add additional speech therapy to make up for what he lost (although that was only one day a week for 45 min). It may not be perfect, but for us, it was a better option than nothing, and the school was willing to help.

Onyx Panthyr

Gods, I fucking hate insurance companies and their bullshit. People improve at their own pace; who the hell are they to disagree with the assessments and treatment recommendations of your doctors?? That's happened to me more than once, most recently with the denial of continued therapy for shifting my shoulder out of place after a fall. >: (

You guys are in my prayers. Go get 'em, Rob. This shit has to stop.

Kate

Rob, I do not mean to sound rude so please try and read this that way. Please remember to try and be a little greatful that he has been able to receive these services at all. Here in Michigan once you receive an Autism diagnosis your insurance (private or Medicad) is NOT required to cover ANYTHING they deem as Autism related. Law was recently passed and now starting in October that will all change. We have not been able to get any services for my son outside of school because of this. Take what you have learned and continue to teach him at home for the time being. I am not sure what you have in Ohio but try and look into programs that may help bring those things to your home. Here in Michigan we have, Early Head Start, Great Parent/ Great Start Collaborative as well as other programs that are income based. The programs I mentioned above are run through our Human Development Commission.

Lost_and_Tired

I\’m not offended. However, I have to say that it\’s not about being grateful its about not losing him. He has already missed 2 weeks of therapy and is already moving backwards. It\’s about soulless micro management that doesn\’t give a damn about our kids.

They view them as an expense and an expendable one at that and that is unacceptable… So while I understand that I should be grateful for what he has had, it doesn\’t change the fact that taking it away from him isn\’t a life changing event.

I will not lose my son and if he needs speech or whatever else, I will stop at nothing until he gets it…

Again, I took no offense to your comment and I use understand your point. 🙂

Caryn

We are Having the same problem. Cigna insurance has denied all therapies Due to my twins’ diagnosis.

Lost_and_Tired

This has got to stop. I don't know how we go about making the change but it needs to happen. I wish you the best of luck, I know how uphill this battle is. However, an option to think about is disability. That something we are forced to look into at this point.

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