Guest guest Posted July 10, 2000 Report Share Posted July 10, 2000 Hi Some alternatives are mental health clinics or free clinics at universities or colleges.Our HMO pays for my daughter's psychologist and psychiatrist and we pay 10% of the cost of the visit. Theresa in SC Insurance Issues > Our 2 1/2 year old was just diagnosed with OCD. I have him on an HMO > and PSO plan. I can not afford the meds, and > Psychiatrist/Psychologist even with insurance. I think we make too > much to qualify for assistance, anyone else facing these issues? > > > ------------------------------------------------------------------------ > 0% Introductory APR! > Instant Approval! > Aria Visa - get yours today. > 1/6035/7/_/531051/_/963269488/ > ------------------------------------------------------------------------ > > You may subscribe to the OCD-L by emailing listserv@... . In the body of your message write: subscribe OCD-L your name. The Archives, Files, and Features List for the may be accessed by going to , enter your email address and password, then point and click. Subscription issues, problems, or suggestions may be addressed to Louis Harkins, list owner, at harkins@... . > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 10, 2000 Report Share Posted July 10, 2000 Theresa~ Thank you for the alternative ideas. We have just begun the process of getting treatment for Ian. My head is still spinning from figuring out the comprehensive benefits from the insurance companies. I hope you get some good info. on changing meds for your daughter. I can't be of any help since we just started Ian on Luvox a month ago. Joy - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2001 Report Share Posted October 28, 2001 I hope you have good luck with your insurance. Ours, United Healthcare, has been great and covers just about anything -- all we have to pay is our regular deductible. I would have given anything for speech, OT and early intervention for my daughter. We didn't have any autism-specific therapies for her until she was 10 years old. Are you getting your services through First Steps? I think that is wonderful, but it wasn't around when my daughter (now 15) was that age. How things have changed over the years -- and I hope they only get better and better. Tamara --- columbo1@... wrote: > Hi, > I just joined this group and will be taking my > daughter to UCLA for > formal diagnosis next week. I have also spent the > majority of the > afternoon being as pleasant as possible with my > behavioral health > provider and my medical provider to see how much of > my appt. is > covered. What does the future hold as far as autism > goes in > California if I get a diagnosis of Autism? Does > anyone have any > ideas how I can get the ABA or whatever treatment > for my daughter. I > now receive 1 hour of OT, 1 hour of Speech and 5.5 > hours of early > intervention a week through the regional center. > > Any suggestions would be helpful. > > Thanks > > Judy > > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2001 Report Share Posted October 29, 2001 Thanks for the reply. My luck has run out with the insurance company. The medical insurance won't cover the visit because the billing code is for a behavioral health consult. The doctor is not an MD so she can't charge for a normal medical office consult and my behavioral health insurance will only cover $35 since UCLA is not in there network. I'll figure out something I guess. Anyway, I get to use Baby Steps right now. It is a great help for my daughter. She still has 7 months until she gets pushed into the school system at age 3. How is your daughter doing? I think about the future and wonder what it will hold. Are you in California? Thanks Again for the info. Judy > > Hi, > > I just joined this group and will be taking my > > daughter to UCLA for > > formal diagnosis next week. I have also spent the > > majority of the > > afternoon being as pleasant as possible with my > > behavioral health > > provider and my medical provider to see how much of > > my appt. is > > covered. What does the future hold as far as autism > > goes in > > California if I get a diagnosis of Autism? Does > > anyone have any > > ideas how I can get the ABA or whatever treatment > > for my daughter. I > > now receive 1 hour of OT, 1 hour of Speech and 5.5 > > hours of early > > intervention a week through the regional center. > > > > Any suggestions would be helpful. > > > > Thanks > > > > Judy > > > > > > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2001 Report Share Posted October 30, 2001 With early intervention your daughter's future should be much more promising than my daughter's was. I work in the field of developmental disabilities and have seen a lot of progress from kids who had help from an early age. But I am thankful that my daughter's life is as normal as it is. She has some OCD along with the autism, which complicates things, but she is very smart. In fact, when we have her Individual Education Plan next week I am going to see if she can't be challenged a bit more. She was at home one day last week but had her school work with her and got it all finished in one hour! She is in the Special Ed. program, mainly because she is the first child with full-blown autism to go through our school system and they just didn't know what to do with her. She has typical teenage interests -- clothes, pop music, makeup, etc. and when I walk into school with her she walks a few feet ahead and acts like " Who IS this woman and WHY is she following me? " just like any other teenager. She speaks and her speech is more fluent all the time. One of her complications was that she had repeated low grade ear infections during the time when her speech should have been developing and that threw her way back. Jan has a neat sense of humor and many endearing qualities. I think that one of the compensatory gifts that God gives to these children is a certain charm which endears them to others. I wish both you and your daughter much success in your fight against autism. Tamara --- columbo1@... wrote: > Thanks for the reply. My luck has run out with the > insurance > company. The medical insurance won't cover the visit > because the > billing code is for a behavioral health consult. > The doctor is not > an MD so she can't charge for a normal medical > office consult and my > behavioral health insurance will only cover $35 > since UCLA is not in > there network. I'll figure out something I guess. > Anyway, I get to > use Baby Steps right now. It is a great help for my > daughter. She > still has 7 months until she gets pushed into the > school system at > age 3. How is your daughter doing? I think about > the future and > wonder what it will hold. Are you in California? > > Thanks Again for the info. > > Judy > > > > > Hi, > > > I just joined this group and will be taking my > > > daughter to UCLA for > > > formal diagnosis next week. I have also spent > the > > > majority of the > > > afternoon being as pleasant as possible with my > > > behavioral health > > > provider and my medical provider to see how much > of > > > my appt. is > > > covered. What does the future hold as far as > autism > > > goes in > > > California if I get a diagnosis of Autism? Does > > > anyone have any > > > ideas how I can get the ABA or whatever > treatment > > > for my daughter. I > > > now receive 1 hour of OT, 1 hour of Speech and > 5.5 > > > hours of early > > > intervention a week through the regional center. > > > > > > > Any suggestions would be helpful. > > > > > > Thanks > > > > > > Judy > > > > > > > > > > > > __________________________________________________ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 6, 2006 Report Share Posted June 6, 2006 , I have been meaning to thank you for the info below about insurance. It will be an interesting summer studying for the bar and getting ready for surgery (I didn't realize how overwhelmed I would be because I naively thought I wouldn't have to study as much for the bar as it now appears that I have to.) I was/am just being a little paranoid that after my operation August 4, I might have complications that require expensive doctor visits in Sept/Oct which is after my insurance expires Aug. 31. It does seem that as long as things go fairly well that I won't have to see anyone in Sept./Oct. since my follow-up appointment should be in Aug. In case it is useful to anyone, I found a helpful site about insurance http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html. It says that group insurance plans have to count your prior insurance coverage towards any pre-existing condition waiting periods as long as your gap between coverage was less than 63 days. So, I should be fine in that respect for the group insurance I will have when I start working. I spoke to an insurance broker about individual coverage for before I start working. She indicated that the companies she deals with can either charge me more or refuse to cover me at all based on my pre-existing conditions. Which is why I am concerned about getting coverage for Sept./Oct. However, I did read the following at the website I mentioned below that implies I may qualify for some HIPAA guaranteed coverage (but I don't know if this excludes coverage for pre-existing conditions). " What if I am unable to obtain new group health plan coverage? You may be able to purchase an individual insurance policy. HIPAA guarantees access to individual policies to eligible individuals. Eligible individuals: Have had coverage for a least 18 months without a significant break in coverage where the most recent period of coverage was under a group health plan Did not have their group coverage terminated because of fraud or nonpayment of premiums Are ineligible for COBRA continuation coverage or if offered COBRA continuation coverage (or continuation coverage under a similar state program), have both elected and exhausted their continuation coverage " Vicki > > > > > My only slight concern is that my student insurance ends Aug 31, > and > > I won't have insurance through my new job until late Sept or mid > > Oct. I have been looking into individual policies but am worried > > they will turn me down once they find out about my surgery. So, > > I'll have to see. > > Hey Vicki - my understanding is that as long as you don't go more > than 60 days (I think, it may actually be 61 days) without coverage, > they cannot turn you down based on a pre-existing condition. Even if > they do hit you with the pre-existing thing, it's generally a 12 > month waiting period. After your follow ups, you should be fine. I > follow up every 2-3 years for a barium swallow and EGD. > Make sure to ask but it's good to go in with some idea of the > guidelines. > > Good luck on the exams and your surgery. Wow! What are you going to > do with yourself after all of these big stresses in your life are > over?? lol > You've got quite the summer planned. > > Happy Swallowing! > - in Va. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2008 Report Share Posted January 23, 2008 Hello Laurie, I found myself in a very similar situation today. I am a graduate student and I have two different insurances. One is Medicare Plan A (NOT Plan and the other one doesn't cover pre-existing conditions (college student insurance). I am finding this frustrating. I don't know what to do either. If I apply for Medicare Plan B then I won't be able to get coverage until June. That's a long time to wait for a CI. On Jan 23, 2008 11:13 PM, <ldpullins@...> wrote: > Hello Everyone, > > I'm coming out of lurkdom to ask for some advice, help, or suggestions > from > you regarding health insurance. Has anyone on this list had to change > insurance companies only to find out that cochlear implants are a > pre-existing > condition and not covered by the new policy? Or if you did change, and > have > benefits covered, how did you do it? > > My husband and I are recently self employed and our COBRA benefits run out > > soon. We are in the process of trying to find a new health insurance and > it > is mind boggling and confusing! We've always had a group policy where > someone > else did the work for us. I just found out today that Blue Cross/Blue > Shield will not cover any of my expenses related to my cochlear implants > if we get > a policy through them because it is a pre-exisiting condition. They will > not cover my batteries or my mapping sessions, etc. I've lived with a > hearing > loss for most of my life and have never run into this issue before. Or, is > > this something I should fight for? I'd be very interested in hearing about > > your expenses or getting some advice. > > Help! > > Laurie in TN > Severe/Profound Hearing Loss since 1957 > Implanted with Freedom 8/30/05 (left ear) > Activated 9/20/05 > Implanted with Freedom 1/30/07 (right ear) > Activated 03/01/07 > _http://lauriescidance.blogspot.com_ (http://lauriescidance.blogspot.com/) > > > **************Start the year off right. Easy ways to stay in shape. > http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2008 Report Share Posted January 24, 2008 In a message dated 1/24/2008 12:00:28 AM Eastern Standard Time, ldpullins@... writes: I'd be very interested in hearing about your expenses or getting some advice. Oops. I meant, " I would be very interested in hearing about your experiences and would appreciate any help, comments, or advice. " Thanks! Laurie in TN Severe/Profound Hearing Loss since 1957 Implanted with Freedom 8/30/05 (left ear) Activated 9/20/05 Implanted with Freedom 1/30/07 (right ear) Activated 03/01/07 _http://lauriescidance.blogspot.com_ (http://lauriescidance.blogspot.com/) **************Start the year off right. Easy ways to stay in shape. http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2008 Report Share Posted January 24, 2008 Laurie, I was employed by the corporate world until 2002, used COBRA till it expired in early 2004 then switched to Anthem BCBS in CT as a self employed small business owner. We never had problems with the switch and my son had been implanted back in 2000. Anthem has always covered mappings and such and even covered his bilateral surgery in 2005 and freedom upgrade in 2007. It's my understanding that as long as you have continueous coverage (no gaps of even a few hours), there is no such thing as a pre-existing condition. Can you contact your local Chamber of Commerce and see who they recommend for health insurance? We got our agent that way and he has been great working the insurance system to find out the best carrier for us. He sort of does the job that the HR person in corporate America did for us. Regards, Suzanne in CT mom to Sam, 8yo N24C 09/00 left N24 double array 06/05 right freedom both -------------- Original message from ldpullins@...: -------------- > Hello Everyone, > > I'm coming out of lurkdom to ask for some advice, help, or suggestions from > you regarding health insurance. Has anyone on this list had to change > insurance companies only to find out that cochlear implants are a pre-existing > condition and not covered by the new policy? Or if you did change, and have > benefits covered, how did you do it? > > My husband and I are recently self employed and our COBRA benefits run out > soon. We are in the process of trying to find a new health insurance and it > is mind boggling and confusing! We've always had a group policy where someone > else did the work for us. I just found out today that Blue Cross/Blue > Shield will not cover any of my expenses related to my cochlear implants if we > get > a policy through them because it is a pre-exisiting condition. They will > not cover my batteries or my mapping sessions, etc. I've lived with a hearing > loss for most of my life and have never run into this issue before. Or, is > this something I should fight for? I'd be very interested in hearing about > your expenses or getting some advice. > > Help! > > Laurie in TN > Severe/Profound Hearing Loss since 1957 > Implanted with Freedom 8/30/05 (left ear) > Activated 9/20/05 > Implanted with Freedom 1/30/07 (right ear) > Activated 03/01/07 > _http://lauriescidance.blogspot.com_ (http://lauriescidance.blogspot.com/) > > > > > **************Start the year off right. Easy ways to stay in shape. > http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489 > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2008 Report Share Posted January 24, 2008 Hi Laurie, I faced a similar problem. I am self-employed, but my wife has always worked in companies with group plans, so my insurance has been on those group plans. My wife's last employer was going out of business at the end of last year (mortgage industry meltdown) -- right when my CI surgery was scheduled. I barely made it in under the wire for the surgery under my HMO. Since the company was terminating, COBRA was not an option, so we had to apply for individual insurance to fill the gap until my wife enters a new group plan. My initial application for an individual HMO with Blue Shield was denied due to my (at the time) pending CI surgery. My only option was to get what is called a " Guaranteed Issue " plan. These plans are required under the HIPAA act. In my case, the GI plan was only available as a PPO and was twice as expensive as a normal plan. But at least I am covered, although now I pay more for mappings, etc. My recommendation is to try to get into a group HMO plan, since there will be no pre-existing condition limitation. I think there are small business pools for this available. Otherwise, look into a Guaranteed Issue plan, but be aware that you must have continuous group or COBRA insurance for a minimum time (18 or 24 months I believe). If you need to do the GI plan, you will probably find it cheaper to do an individual plan for yourself, separate from husband and/or family. If at all possible, don't let your insurance lapse. Good luck, and be sure to report back what you find. -Jeff Insurance Issues > Hello Everyone, > > I'm coming out of lurkdom to ask for some advice, help, or suggestions > from > you regarding health insurance. Has anyone on this list had to change > insurance companies only to find out that cochlear implants are a > pre-existing > condition and not covered by the new policy? Or if you did change, and > have > benefits covered, how did you do it? > > My husband and I are recently self employed and our COBRA benefits run out > soon. We are in the process of trying to find a new health insurance and > it > is mind boggling and confusing! We've always had a group policy where > someone > else did the work for us. I just found out today that Blue Cross/Blue > Shield will not cover any of my expenses related to my cochlear implants > if we get > a policy through them because it is a pre-exisiting condition. They will > not cover my batteries or my mapping sessions, etc. I've lived with a > hearing > loss for most of my life and have never run into this issue before. Or, > is > this something I should fight for? I'd be very interested in hearing > about > your expenses or getting some advice. > > Help! > > Laurie in TN > Severe/Profound Hearing Loss since 1957 > Implanted with Freedom 8/30/05 (left ear) > Activated 9/20/05 > Implanted with Freedom 1/30/07 (right ear) > Activated 03/01/07 > _http://lauriescidance.blogspot.com_ (http://lauriescidance.blogspot.com/) > > > > > **************Start the year off right. Easy ways to stay in shape. > http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489 > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2008 Report Share Posted January 25, 2008 Hi, June is like 4 months away. that is NOT a long time to wait. YOu need to meet with an implant team, make sure you are a candidate, and then choose which implant you want. There are various tests that need to be done, like CT scans and MRIs. None of these happen over night. So 4 months is not a long time to wait. Apply for the Part B NOW and get the ball rolling. I am finding this frustrating. I don't know what to do either. If I apply for Medicare Plan B then I won't be able to get coverage until June. That's a long time to wait for a CI. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 25, 2011 Report Share Posted August 25, 2011 I agree with Sally. We treat patients all the time who are immigrants and have had surgery elsewhere. I've never heard of people having problems with insurance after that. Fills and such for a band is a different story. That's not a complication of the band, but a known follow-up procedure, and I know people with bands can have a heck of a time finding care here afterwords if their procedure was not done here. Danae (M.D.) Quote Link to comment Share on other sites More sharing options...
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