Guest guest Posted May 25, 2006 Report Share Posted May 25, 2006 Hi - Jumping in here... Folks have had mixed results with EI - some great, some awful. If I were you and there were a shot in heck of getting private therapy, I'd go for it - even if it's temporary. Marina > > >You should get a dr. (specialist) to diagnose and provide your insurance > > >with a letter of medical necessity for this speech therapy. This letter > > >will indicate that Apraxia is a medical condition that requires Speech > > >Therapy as a treatment. It should also include the medical codes for > > >Apraxia. 784.69 (I think). My son also needed OT for his low muscle tone > > >(Hypotonia). > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 28, 2006 Report Share Posted June 28, 2006 In a message dated 6/28/06 9:33:25 AM, suepet2000@... writes: > as offered insurance through AIG which is fairly > inexpensive. Has anyone ever heard of AIG insurance? I am on enbrel > and also methotrexate so the need for a good prescription plan is > necessary. Please help. Thank > I don't think any plan will pay for all the Enbrel. Most have limits, eg, $5000 a year. Pris Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 28, 2006 Report Share Posted June 28, 2006 Sue I could not find anything on AIG offering health insurance to individuals. They may have it but I could not find it on the web site. My wife has health coverage with Blue Cross/Blue Shield and she pays $520 per month for her coverage, Blue Select. That was the cheapest we could find for decent coverage for a woman her age. She is not old enough to get Medicare yet. Health care coverage is becoming increasingly more expensive and many Americans cannot afford it. Our legislators can't relate because they have the finest insurance and pay nothing for it. I hope you can find a good solution for you. 2520 " il faut d'abord durer " Hemingway [ ] Insurance > Hi everyone, > > I need some help here with medical insurance. I was layed off from my > job and my insurance ends August 1st. I have been researching > insurance companies and have found because I have RA the cost is > unbelievable. I was offered insurance through AIG which is fairly > inexpensive. Has anyone ever heard of AIG insurance? I am on enbrel > and also methotrexate so the need for a good prescription plan is > necessary. Please help. Thanks > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 28, 2006 Report Share Posted June 28, 2006 > > Hi everyone, > > I need some help here with medical insurance. I was layed off from my > job and my insurance ends August 1st. I have been researching > insurance companies and have found because I have RA the cost is > unbelievable. I was offered insurance through AIG which is fairly > inexpensive. Has anyone ever heard of AIG insurance? I am on enbrel > and also methotrexate so the need for a good prescription plan is > necessary. Please help. Thanks > I'd call AIG if I were you...Most insurance companies offer many different plans with different levels of benefits. The only way to know what is or isn't covered would be to ask them directly. Good luck- dordale Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 28, 2006 Report Share Posted June 28, 2006 Also if you are on unemployment you qualify for medical assistance programs from the drug companies. I have found that that most of our drugs, the companies have medical assistance programs. If you have children at home you would qualify for a state insurance program, like WI has badger care for minor children and their mother. in WI dordale8 <dordale8@...> wrote: > > Hi everyone, > > I need some help here with medical insurance. I was layed off from my > job and my insurance ends August 1st. I have been researching > insurance companies and have found because I have RA the cost is > unbelievable. I was offered insurance through AIG which is fairly > inexpensive. Has anyone ever heard of AIG insurance? I am on enbrel > and also methotrexate so the need for a good prescription plan is > necessary. Please help. Thanks > I'd call AIG if I were you...Most insurance companies offer many different plans with different levels of benefits. The only way to know what is or isn't covered would be to ask them directly. Good luck- dordale --------------------------------- Music Unlimited - Access over 1 million songs.Try it free. --------------------------------- Want to be your own boss? Learn how on Small Business. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 29, 2006 Report Share Posted June 29, 2006 --- In , " Kennedy " <ikennedy2@...> wrote: > > Sue > > I could not find anything on AIG offering health insurance to individuals. > They may have it but I could not find it on the web site. My wife has health > coverage with Blue Cross/Blue Shield and she pays $520 per month for her > coverage, Blue Select. That was the cheapest we could find for decent > coverage for a woman her age. She is not old enough to get Medicare yet. > Health care coverage is becoming increasingly more expensive and many > Americans cannot afford it. Our legislators can't relate because they have > the finest insurance and pay nothing for it. I hope you can find a good > solution for you. > > > 2520 > " il faut d'abord durer " Hemingway > > [ ] Insurance > > > > Hi everyone, > > > > I need some help here with medical insurance. I was layed off from my > > job and my insurance ends August 1st. I have been researching > > insurance companies and have found because I have RA the cost is > > unbelievable. I was offered insurance through AIG which is fairly > > inexpensive. Has anyone ever heard of AIG insurance? I am on enbrel > > and also methotrexate so the need for a good prescription plan is > > necessary. Please help. Thanks > > > >sue, i am still battleing to get insurance, i have been turned down so many times now i stopped counting. because we make to much money i cant even get on a co assistance program with enbrel. they told me that it was more people who were living in poverty. i was so upset about it when my husband asked me what was wrong, i started to cry, told him because that we werent poverty stricken i couldnt get any kind of assistance from them. just doesnt seem right. now the only choice i have is to quit my job, try for disablity. i plan on taking my last vac in aug and when i go back im putting in my notice. i havent been able to start on enbrel like i was suppose to do last month becuase the cost is so high. brenda > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 29, 2006 Report Share Posted June 29, 2006 aig car insurance is a rip off, the medial part might be ok. Kitt --- In , " Kennedy " <ikennedy2@...> wrote: > > Sue > > I could not find anything on AIG offering health insurance to individuals. > They may have it but I could not find it on the web site. My wife has health > coverage with Blue Cross/Blue Shield and she pays $520 per month for her > coverage, Blue Select. That was the cheapest we could find for decent > coverage for a woman her age. She is not old enough to get Medicare yet. > Health care coverage is becoming increasingly more expensive and many > Americans cannot afford it. Our legislators can't relate because they have > the finest insurance and pay nothing for it. I hope you can find a good > solution for you. > > > 2520 > " il faut d'abord durer " Hemingway > > [ ] Insurance > > > > Hi everyone, > > > > I need some help here with medical insurance. I was layed off from my > > job and my insurance ends August 1st. I have been researching > > insurance companies and have found because I have RA the cost is > > unbelievable. I was offered insurance through AIG which is fairly > > inexpensive. Has anyone ever heard of AIG insurance? I am on enbrel > > and also methotrexate so the need for a good prescription plan is > > necessary. Please help. Thanks > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 2, 2006 Report Share Posted August 2, 2006 In a message dated 8/2/2006 2:27:01 AM Eastern Standard Time, leyna1964@... writes: Sorry to ramble....so, does insurance cover implant removal usually?I'm scared to call my insurance to ask them because they always haveto know my insurance ID before they will talk to me-I'm afraid if Itell them I have implants, they will drop me. Leyna, Well... this is a tricky question. I've been through 3 health insurance plans that do not cover it, despite numerous diseases I have. (Even RARE ones.) Including Medicare, make it 4. (Although I've yet to find a Plastic Surgeon who takes Medicare to try to have them fight that with them.) The plans I've had specifically rule out treatment due to complications of cosmetic procedures. Others have fought their insurance companies and won. It just varies, and you'll have to check with yours and see how they handle situations like this. Sometimes, you may have to pay up front and just keep fighting your insurance for reimbursement -and hope you win and get some money back. It's sad, I know, and I know most of us don't have thousands of bucks in our back pocket to pay for an explant if implants make us sick. (We are selling my husband's work truck to pay for mine -or trying to.) Hopefully your insurance will pay, but if not... it's just one of those things you have to consider and say, "Money stands between my living or eventually dying (or dramatically losing the quality of life)," and find a way. Brigite :-\ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 2, 2006 Report Share Posted August 2, 2006 Leyna, Implants can cause so many types of problems that look like other issues, it's impossible to tell you if what you experience is actually implants or something else . .. The good news is that many of the symptoms go away after explant . . . for us, that's our proof. Leave it to the doctor to make the request to the insurance company. They use insurance codes that describe what they are going to do and why . . . You wouldn't call your insurance company if you were going to have any other type of surgery . .. your doctor would. It would be a good idea to read your policy well so you'll have an idea what to expect. That said, once you come to the point where you know your implants have to come out, every ache, pain and symptom can become magnified . . . They were there before, but you were ignoring them and pushing through. . . Monitoring all your symptoms closely can add to the stress you're under . . . . Please focus on getting well . . . not on how sick you feel . .. The additional stress will only make things worse. Start making your plan, break it down to steps, then start taking those steps. Taking action will help reduce stress. Hugs and prayers, Rogene Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 2, 2006 Report Share Posted August 2, 2006 Leyna, Implants can cause so many types of problems that look like other issues, it's impossible to tell you if what you experience is actually implants or something else . .. The good news is that many of the symptoms go away after explant . . . for us, that's our proof. Leave it to the doctor to make the request to the insurance company. They use insurance codes that describe what they are going to do and why . . . You wouldn't call your insurance company if you were going to have any other type of surgery . .. your doctor would. It would be a good idea to read your policy well so you'll have an idea what to expect. That said, once you come to the point where you know your implants have to come out, every ache, pain and symptom can become magnified . . . They were there before, but you were ignoring them and pushing through. . . Monitoring all your symptoms closely can add to the stress you're under . . . . Please focus on getting well . . . not on how sick you feel . .. The additional stress will only make things worse. Start making your plan, break it down to steps, then start taking those steps. Taking action will help reduce stress. Hugs and prayers, Rogene Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 2, 2006 Report Share Posted August 2, 2006 Oh gee....not good. My husband and I are poverty level as it is-he makes $11 an hour, and I make $7.45. We're barely making it as it is, and have not saved a single penny in years-it's paycheck to paycheck for us. This is so not good. --- KissofSadness@... wrote: > > > In a message dated 8/2/2006 2:27:01 AM Eastern > Standard Time, > leyna1964@... writes: > > Sorry to ramble....so, does insurance cover implant > removal usually? > I'm scared to call my insurance to ask them because > they always have > to know my insurance ID before they will talk to > me-I'm afraid if I > tell them I have implants, they will drop me. > > > > Leyna, > > Well... this is a tricky question. I've been through > 3 health insurance > plans that do not cover it, despite numerous > diseases I have. (Even RARE ones.) > Including Medicare, make it 4. (Although I've yet to > find a Plastic Surgeon > who takes Medicare to try to have them fight that > with them.) The plans I've > had specifically rule out treatment due to > complications of cosmetic procedures. > > Others have fought their insurance companies and > won. It just varies, and > you'll have to check with yours and see how they > handle situations like this. > Sometimes, you may have to pay up front and just > keep fighting your insurance > for reimbursement -and hope you win and get some > money back. > > It's sad, I know, and I know most of us don't have > thousands of bucks in our > back pocket to pay for an explant if implants make > us sick. (We are selling > my husband's work truck to pay for mine -or trying > to.) Hopefully your > insurance will pay, but if not... it's just one of > those things you have to > consider and say, " Money stands between my living or > eventually dying (or > dramatically losing the quality of life), " and find > a way. > > Brigite :-\ > > > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 7, 2006 Report Share Posted December 7, 2006 I have never heard of probable MS.. did you get a 2nd opinion? I would go to another Neuro. I did... I'm on short term, but did it through my company. Basically, I woke up one day and had a flare up and called the my neuro and he put me on IV steriods and took me out of work. I just filled out papers and so did he and sent them into the state. My short term ends in January, so I need to go back to or go on long term...debraa_lydon <debraa_lydon@...> wrote: Hello,I had my first attack in July 2006, spent a few days in the hospital, was treated with steroids and received lots of testing. The MRI and spinal tap came back positive for MS. However I haven't been given an MS diagnosis because I was told I need 4 out of 5 criteria. I have 3 out of 5- the positive spinal tap, abnormal MRI showing lesions, and an attack. Therefore I've been diagnosed as "Probable MS". Since this experience I am trying to get short term disability but am learning that I'm now considered by some, or all, to be uninsurable. Prior to my "attack" I was 100% healthy. Since my attack, I feel 100% healthy, I'm taking LDN daily and feel like myself before the attack. My question is does anyone have any advise on short term disability or life insurance and how I can get them? I'm applying for it through my company but don't feel too optimistic about it. I am now considered "uninsurable".Thanks,Debra Want to start your own business? Learn how on Small Business. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 7, 2006 Report Share Posted December 7, 2006 When I got dx in 1993. I was called probable MS for years. I became just MS in like 1999. I always felt I had it but they wouldn't say that. To me, it's really obvious now. -- Re: [low dose naltrexone] Insurance I have never heard of probable MS.. did you get a 2nd opinion? I would go to another Neuro. I did... I'm on short term, but did it through my company. Basically, I woke up one day and had a flare up and called the my neuro and he put me on IV steriods and took me out of work. I just filled out papers and so did he and sent them into the state. My short term ends in January, so I need to go back to or go on long term...debraa_lydon <debraa_lydon > wrote: Hello,I had my first attack in July 2006, spent a few days in the hospital, was treated with steroids and received lots of testing. The MRI and spinal tap came back positive for MS. However I haven't been given an MS diagnosis because I was told I need 4 out of 5 criteria. I have 3 out of 5- the positive spinal tap, abnormal MRI showing lesions, and an attack. Therefore I've been diagnosed as "Probable MS". Since this experience I am trying to get short term disability but am learning that I'm now considered by some, or all, to be uninsurable. Prior to my "attack" I was 100% healthy. Since my attack, I feel 100% healthy, I'm taking LDN daily and feel like myself before the attack. My question is does anyone have any advise on short term disability or life insurance and how I can get them? I'm applying for it through my company but don't feel too optimistic about it. I am now considered "uninsurable".Thanks,Debra Want to start your own business? Learn how on Small Business. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 7, 2006 Report Share Posted December 7, 2006 Don't know about disability insurance but I tried getting long term health and was denied because of my MS. My advice is not to have it documented until you get your life, longterm, or whatever else you may want immediately. I have not even told my car insurance , they never asked. kiki Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 8, 2006 Report Share Posted December 8, 2006 Kiki, I was diagnosed in 1993 and I have never told my car insurance company. I don't think they need to know. -- Re: [low dose naltrexone] Insurance Don't know about disability insurance but I tried getting long term health and was denied because of my MS. My advice is not to have it documented until you get your life, longterm, or whatever else you may want immediately. I have not even told my car insurance , they never asked. kiki Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 8, 2006 Report Share Posted December 8, 2006 > > Don't know about disability insurance but I tried getting long term health > and was denied because of my MS. My advice is not to have it documented until > you get your life, longterm, or whatever else you may want immediately. I have > not even told my car insurance , they never asked. kiki The diagnosis is definitely a one way door. I was denied group disability insurance because of my optic neuritis. I called and asked the NMSS about financial preplanning. They never returned my call. Heard through the grapevine that they weren't up to helping someone with financial planning like that. I had a mortgage insurance saleslady in my house. When I mentioned MS, she got up and left. There are attorney's out there specializing in disability insurance claims. I called one. The idea of financial preplanning is quite foreign to them and it takes some calm explaining before they can help. My last couple of posts have been off-LDN-topic, so feel free to write me directly or we can go to a different site if you wish. The diagnosis didn't even open the door for LDN. I took me 2 neurologists and one holistic doc before I got my script. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 8, 2006 Report Share Posted December 8, 2006 I did tell my car insurance salesman and found his wife has ms. He also told me there are companies that will give life insurance to msers. kim Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 8, 2006 Report Share Posted December 8, 2006 Kim, I do have life insurance. It probably costs me more than someone that does not have MS but I do have it. -- [low dose naltrexone] Re: Insurance I did tell my car insurance salesman and found his wife has ms. He also told me there are companies that will give life insurance to msers. kim Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2006 Report Share Posted December 9, 2006 really? did he mention what companies would?Kim Zern <kzern2@...> wrote: I did tell my car insurance salesman and found his wife has ms. He also told me there are companies that will give life insurance to msers. kim Access over 1 million songs - Music Unlimited. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 16, 2007 Report Share Posted May 16, 2007 Joanne, I read your postings; they are very helpful! We too have BC/BS and a thirty session limit per year for both PT and OT. Were you ever able to get additional coverage beyond your visit limits? Did a Letter of Medical Necessity get results? My son has diagnoses for 781.3 (generalized ataxia) and 781.4 (SID) and needs continuous PT and OT. He overcame the speech apraxia (for the most part) and now only gets speech in school. Thank you for your help! --beth > > April, > > I would make the appeal in case you may need the private therapy after EI > ends on your childs third birthday. > > You may want to argue the insurance company by telling them it is a medical > necessity versus using educational terminology. We had this problem and I > got my husband's human resource department involved in writing a letter to > the insurance company stating reasons for medical necessity and asking the > audiologist and other professionals to use medical terms in their reports. > > Only 10% fight the insurance companies on their denials! 100% win their > cases after a long drawn out fight! Don't give up . . . > > They denied us on the code for Apraxia 784.69 claiming its developmental > which we all know it's NOT, but they approved the therapy for the code for > Language processing disorder 388.43. > > A great code to use if you have a child with apraxia is 781.3 which is " lack > of muscle coordination /coordination disorder. " This shows a physical > diagnosis, which is typically covered, versus a developmental diagnosis, > which is typically not covered. > > We had Blue Cross and have a 20 session limit per year. My son has apraxia, > aphasia (codes are 784.3,784.69 & 784.5) Now we are with HealthNet. Your > files follow you for life. > > Let your PT & OT know your codes for speech/language and not to use any > developmental/educational codes. (just medical necessity). > > all the best, > Joanne Mulholland > > Here is an archived note regarding appeals to insurance companies: > > In order to get your insurance company to comply with speech therapy all > evaluation and treatment reports should be stated in medical terms, not > educational goals. > > A speech pathologist (not speech therapist) should have given you a written > evaluation report stating what tests were given and the medical diagnosis > for your child with a treatment plan. > > Your pediatrician cannot evaluate but recommend a specialist to go to for > further evaluation. > > I would appeal the HMO and state the following: > 1) a specific description of the charges being appealed, 2) the names of > people contacted at the insurance company with the dates the conversations > took place, 3) concise explanation of what is being requested, either a > re-verification of the policy requirements or asking for an exception to the > rules, in either case, a strong argument defining the position of the letter > writer must be stated precisely, and 4) the anticipated result by the letter > writer is clearly explained. > > Before writing a letter: > 1) Review your policy booklet to verify if a) experimental procedures are > not covered and that if the medical procedure is considered experimental. > If the information is not provided, contact customer service for an answer > and document your conversation with them. Call customer service twice and > get two different people on the phone. This is a good test to see if they > provide you with the same answer. If they don't, you should complain. > Remember, you are trying to prove medical necessity. > > 2) If it is considered experimental, then verify that this procedure is FDA > approved by visiting the FDA website http://www.fda.gov, calling them > directly, or by contacting your State Insurance Department. A standard rule > would be if Medicare covers the procedure, most private health plans do as > well. > > 3) If the medical procedure is not FDA approved, then another option would > be to find two articles within respected medical journals that support the > use of your proposed medical treatment. Submit a copy of these two > articles, along with a letter of medical necessity and total costs from your > medical provider to your health plan for review. > > 4) If the treatment is FDA approved, then contact the health plan's Medical > Director to ask why the health plan has not approved coverage for this > procedure. This is where it may benefit you to befriend a nurse within the > health plan and explain your situation. > > 5) If all of these avenues fail, consider negotiating a lower price between > your medical provider and health plan. After all, your health plan wants to > save money > > 6) Write letters to every manager, director, etc. you could find who work at > the health plan until you get your " YES " . > > 7) Contact your Department of Insurance for additional assistance. I'm not > sure what state your from, but everyone has a Office of the Commissioner of > Insurance. OCI investigates every complaint it receives in order to assist > you in resolving your complaint, and to determine if the insurance company > is complying with all state insurance laws. > > Good Luck! > > Joanne Mulholland > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 7, 2007 Report Share Posted November 7, 2007 If your policy specifically states that speech much be lost (check the actual policy and see what is written) then you're out of luck and won't get it covered. If that's the case, go your employer and see if there is a policy, under aetna, where they would cover the speech. Then see if your employer will give you an over-ride for that higher policy. This will cost your employer a higher premium for your child but many employers will help you out once you show them documentation from your doctor, etc. Ours gave us an over ride that doubled our visits. Kris The Knitting Wannabe http://knittingwannabe.typepad.com Sonny & Shear: The I’ve Got Ewe, Babe Yarn Shop http://www.sonnyandshear.com > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 7, 2007 Report Share Posted November 7, 2007 That's a bunch of B.S.! We have Aetna and they tried that on us....But my husband's policy does cover Speech Therapy. So, what Aetna had us do since I told him my son has never started talking therefore he can't retrieve something he's never had....with Apraxia, you have to be taught how to say words! So, they requested a letter of medical necessity from our nuero-developmental pediatrician who diagnosed him. I faxed over the letter with the codes 784.69 (I think) and after 2 months of follow-up...calls, them losing our case file, me having to remind 4 of their reps of the case history....and finally, my telling them I better speak to a supervisor otherwise, I will get a lawyer. They approved. Our policy is for 60 sessions a year..not alot but something...and the Preschool was giving him speech 3x a week....so it worked. Today, @ 6y.o. he is talking...in sentences..not great grammatically and not a very big vocabulary...but he is talking! More & more everyday. Don't take " no " for an answer. " emonline2000 " <emonline2000@yah oo.com> To Sent by: childrensapraxian cc et@... m Subject [ ] Insurance 11/07/2007 01:57 PM Please respond to childrensapraxian et@... m I am just wondering if anyone is getting speech therapy covered by insurance. We have Aetna, and it specifically says that speech must be " lost " and it will not pay for speech to be acquired. When I spoke to the company, they told me that learning to speak is educational, and I needed to go through the school district. We tried that, and for us, it just doesn't come close to private therapy. (It makes me a little angry frankly that such a basic skill, such as being able to talk, is considered educational!) As an aside, I know others have had their chlid tested for celiac. I am just wondering if your insurance paid for it. My doctor agreed to test for it, among other things that had posted. Our insurance denied coverage, calling it an " immuno-assay " and said it was " investigational. " We are getting pretty accustomed to our insurance company saying no. They also denied hippotherapy and OT! ----------------------------------------- This transmission may contain information that is privileged, confidential, legally privileged, and/or exempt from disclosure under applicable law. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or use of the information contained herein (including any reliance thereon) is STRICTLY PROHIBITED. Although this transmission and any attachments are believed to be free of any virus or other defect that might affect any computer system into which it is received and opened, it is the responsibility of the recipient to ensure that it is virus free and no responsibility is accepted by JP Chase & Co., its subsidiaries and affiliates, as applicable, for any loss or damage arising in any way from its use. If you received this transmission in error, please immediately contact the sender and destroy the material in its entirety, whether in electronic or hard copy format. Thank you. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 7, 2007 Report Share Posted November 7, 2007 I have BlueCrossBlueShield and they paid something like 20 or 30% of the speech therapy & ocupational therapy for my son for about 1.5 years. I never looked into it too much so I am not exactly sure what the percentage was. If any one is really interested I can easily go back through the records. He has been is in public special ed preschool since August and get both once a week in school. Thank God, because we were truly going broke even though it was parially covered. [ ] Insurance I am just wondering if anyone is getting speech therapy covered by insurance. We have Aetna, and it specifically says that speech must be " lost " and it will not pay for speech to be acquired. When I spoke to the company, they told me that learning to speak is educational, and I needed to go through the school district. We tried that, and for us, it just doesn't come close to private therapy. (It makes me a little angry frankly that such a basic skill, such as being able to talk, is considered educational! ) As an aside, I know others have had their chlid tested for celiac. I am just wondering if your insurance paid for it. My doctor agreed to test for it, among other things that had posted. Our insurance denied coverage, calling it an " immuno-assay " and said it was " investigational. " We are getting pretty accustomed to our insurance company saying no. They also denied hippotherapy and OT! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 27, 2008 Report Share Posted January 27, 2008 I don't know this insurer, but there are lots of sample appeals in the files section for the group. Some will be for " cosmetic " reasons. you'll want to site studies about possible complications for plagio (TMJ etc). -christine sydney 2 yrs starband grad > > I was just wondering if anyone here has dealt with the same insurance > company that I am dealing with. I live in Port Orchard WA and have > First Choice Health(Sound Health and Wellness) formerly known as Retail > Clerks Welfare Trust. They are denying my sons helmet cost because they > claim it is " cosmetic " . I just wanted to know if anyone has dealt with > them and if you appealed or not and how it went. Thank you! > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 4, 2008 Report Share Posted May 4, 2008 we had an impossible time getting speech therapy covered. after about 6 months our speech therapist tried to submit the therapy under a chewing problem which my son also has. Im not sure what the name of this condition is or the code but Im told that most kids with apraxia have a problem chewing their food. It has been covered for 2 years now. > > Hi, > > Does anyone know what the diagnosis codes are for apraxia and auditory > processing disorder that are being reimburse by blue cross blue shield > of michigan???? or by any other insurance company?? I am looking for > codes that do not fall under 'developmental'. Thanks in advance. > > > Mom to JaeKi 5.10 and Jonah 4.8 mths > Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.