Re: Pre-existing condition

[Guest guest]

Our group health insurance through my husband's employer does not consider DS a pre-existing condition. However, there is only $1000 each for OT and speech per year. But I think a lot of insurance is like that. They have covered endocrinologist, cardiologist, ent, orthopedist, podiatrist, ped. Of course she is not seeing these docs for diagnosis DS. Her diagnosis for speech is apraxia and for OT it is low muscle tone and SID.

What is it that your insurance isn't covering because of pre-existing condition? Do they cover that same service for other diagnosis? You may be able to fight this discrimination.

ette

mom to Faith (10)DS

-------------- Original message from " Bolduc" : --------------

I just heard on the news that the president candidates want to make sure that autism is not considered a pre-existing condition and that insurance has to pay for therapies.

I have 2 daughters with Trisomy 10q/5p and Trisomy 21/MDS. They are considered pre-existing and the insurance company will not pay for therapies, medical equipment or anything that will help them.

Isn't this discrimination against my kids and your kids? I know some of you have written that your child has dual diagnosis with autism. How will they handle that? Example: Your child was born with DS and years later diagnosised with autism. Will the insurance then cover everything or just the autism portion?

Hope I didn't start anything here but I am upset as I think all kiddos with any type of disabilities should be covered and get the therapies they need and get rid of the pre-existing condition clause for them. They did not ask to be born with their conditions and how can it be pre-existing when you find out after birth?

Proud mom to Jezeca, 5, Trisomy 10q/5p

& Zephany, 22 months, Trisomy 21/MDS?

[Guest guest]

pbeurrier@... wrote: Our group health insurance through my husband's employer does not consider DS a pre-existing condition. However, there is only $1000 each for OT and speech per year. But I think a lot of insurance is like that. They have covered endocrinologist, cardiologist, ent, orthopedist, podiatrist, ped. Of course she is not seeing these docs for diagnosis DS. Her diagnosis for speech is apraxia and for OT it is low muscle tone and SID.What is it that your insurance isn't covering because of pre-existing condition? Do they cover that same service for other diagnosis? You may be able to fight this discrimination.ettemom to Faith (10)DS-------------- Original message from " Bolduc" : -------------- I just heard on the news that the president candidates want to make sure that

autism is not considered a pre-existing condition and that insurance has to pay for therapies. I have 2 daughters with Trisomy 10q/5p and Trisomy 21/MDS. They are considered pre-existing and the insurance company will not pay for therapies, medical equipment or anything that will help them. Isn't this discrimination against my kids and your kids? I know some of you have written that your child has dual diagnosis with autism. How will they handle that? Example: Your child was born with DS and years later diagnosised with autism. Will the insurance then cover everything or just the autism portion? Hope I didn't start anything here but I am upset as I think all kiddos with any type of disabilities should be covered and get the therapies they need and get rid of the pre-existing condition clause for them. They did not ask to be born with their conditions and how can it be pre-existing when you find out after birth? Proud mom to

Jezeca, 5, Trisomy 10q/5p & Zephany, 22 months, Trisomy 21/MDS? (one and only wife to Fred; mom to Kari, Melody, Faith, Heidi, Isaac, Josiah, , Alana, and ! Yes, they're all ours!) Is. 40:31 "They that wait upon the Lord shall renew their strength; they shall mount up with wings as eagles, they shall run and not be weary, they shall walk and not faint."

You rock. That's why Blockbuster's offering you one month of Blockbuster Total Access, No Cost.

[Guest guest]

Hi ! Are your daughters adopted? You are right that this is discrimination! I don't know what can be done about it. Our 's medical needs were covered by my husband's group insurance from his birth, except they had certain limits as far as number of therapy visits per year and stuff like that. We were advised to apply for a state insurance for children, so that we had something to cover whatever our primary insurance might not cover. It wasn't Medicaid, but similar, through a state program called Healthy Start. It is a good thing we had this secondary insurance, because at the end of 2007, my husband's group insurance was phased out, requiring us to purchase an individual insurance plan. The new plan would not cover because of his "pre-existing condition." So, now the state insurance is paying for all 's medical and therapy

needs. I think he can be on this until he is 18. We did apply for another safety net type of insurance called BCMH (Bureau for Children with Medical Handicaps). I thought someone told us that BCMH is required by law to cover a child with a medical condition, if you qualify financially. I assumed this was a national program, but when I Google it, it comes up as a program of our state (Ohio). There should be a program like this in every state! Although I don't even really like the state of OH (my heart is in the WV mountains), I guess I should be really grateful for how they take care of our special needs kids! Blessings! Bolduc wrote: I just heard on the news that the president candidates want to make sure that autism is not considered a pre-existing condition and that insurance has to pay for therapies. I have 2 daughters with Trisomy 10q/5p and Trisomy 21/MDS. They are considered pre-existing and the insurance company will not pay for therapies, medical equipment or anything that will help them. Isn't this discrimination against my kids and your kids? I know some of you have written that your child has dual diagnosis with

autism. How will they handle that? Example: Your child was born with DS and years later diagnosised with autism. Will the insurance then cover everything or just the autism portion? Hope I didn't start anything here but I am upset as I think all kiddos with any type of disabilities should be covered and get the therapies they need and get rid of the pre-existing condition clause for them. They did not ask to be born with their conditions and how can it be pre-existing when you find out after birth? Proud mom to Jezeca, 5, Trisomy 10q/5p & Zephany, 22 months, Trisomy 21/MDS?

You rock. That's why Blockbuster's offering you one month of Blockbuster Total Access, No Cost.

[Guest guest]

Hi ,

No my daughters are not adopted. Everyone always asks me and I haven't figured out why. Guess people aren't use to seeing 2 kids with 2 totally different disabilities in the same family.

We have tried for medicaid, SSI, anything and everything that is available. We have been denied everytime I have tried. And I have tried more than once. Alot of places look at the GROSS income of the family but my husband is self employed and they do not look at the $80,000 to $90,000 expenses coming off the GROSS income. The girls health insurance and house expenses aren't even included in that amount nor is the car payment.

I see all the immigrants getting help and living on welfare here in the US. The US needs to take care of their citizens first!

Re: [DownSyndromeInfoExchange] Pre-existing condition

Hi !

Are your daughters adopted? You are right that this is discrimination! I don't know what can be done about it.

Our 's medical needs were covered by my husband's group insurance from his birth, except they had certain limits as far as number of therapy visits per year and stuff like that. We were advised to apply for a state insurance for children, so that we had something to cover whatever our primary insurance might not cover. It wasn't Medicaid, but similar, through a state program called Healthy Start. It is a good thing we had this secondary insurance, because at the end of 2007, my husband's group insurance was phased out, requiring us to purchase an individual insurance plan. The new plan would not cover because of his "pre-existing condition." So, now the state insurance is paying for all 's medical and therapy needs. I think he can be on this until he is 18. We did apply for another safety net type of insurance called BCMH (Bureau for Children with Medical Handicaps). I thought someone told us that BCMH is required by law to cover a child with a medical condition, if you qualify financially. I assumed this was a national program, but when I Google it, it comes up as a program of our state (Ohio). There should be a program like this in every state! Although I don't even really like the state of OH (my heart is in the WV mountains), I guess I should be really grateful for how they take care of our special needs kids!

Blessings!

Bolduc <jhunter5431charter (DOT) net> wrote:

I just heard on the news that the president candidates want to make sure that autism is not considered a pre-existing condition and that insurance has to pay for therapies.

I have 2 daughters with Trisomy 10q/5p and Trisomy 21/MDS. They are considered pre-existing and the insurance company will not pay for therapies, medical equipment or anything that will help them.

Isn't this discrimination against my kids and your kids? I know some of you have written that your child has dual diagnosis with autism. How will they handle that? Example: Your child was born with DS and years later diagnosised with autism. Will the insurance then cover everything or just the autism portion?

Hope I didn't start anything here but I am upset as I think all kiddos with any type of disabilities should be covered and get the therapies they need and get rid of the pre-existing condition clause for them. They did not ask to be born with their conditions and how can it be pre-existing when you find out after birth?

Proud mom to Jezeca, 5, Trisomy 10q/5p

& Zephany, 22 months, Trisomy 21/MDS?

You rock. That's why Blockbuster's offering you one month of Blockbuster Total Access, No Cost.

[Guest guest]

Stan Klein is the Disability Advisor for Barack Obama, I think he should know about this...he's on CNN (ok it was reported on CNN, don't know where he was) saying he was going to fund special education's 40% commitment, and that he would make Autism not a 'pre-existing' condition...which being in the state of the Governator who has accomplished nothing due to his ignorance of the SYSTEM makes me wonder if Barack is also too green behind the ears to actually MAKE anything happen....anyway, here's Stan's email address: stan@...

I know with my company's insurance they can't deny coverage, but 'private' pay seems to be different..and therapy isn't covered...THAT is where the 'pre-existing' condition comes in....therapy is for REHABILITATION (car accident victim to regain what they lost, stroke victim regain the skills they lost) with d.s. you are born with it so you aren't 'regaining' any skills, since supposidly you didn't have them in the first place...that's where Autism is different...most of the symptoms come after age 2, so you 'could' talk, but now you can't...supposidly.

, Mom to 14, DS, Southern CaliforniaTo succeed in life,you need three things:a wishbone, a backbone and a funny bone.~ Reba McIntyre

Diagnosis Down Syndrome: A Site of Hope for New Parents or Parents with a Prenatal Diagnosishttp://www.leeworks.net/DDS/What to Say to Parents of a Child with a Diagnosishttp://www.leeworks.net/DDS/speech.html

Re: [DownSyndromeInfoExchange] Pre-existing condition

Hi !

Are your daughters adopted? You are right that this is discrimination! I don't know what can be done about it.

Our 's medical needs were covered by my husband's group insurance from his birth, except they had certain limits as far as number of therapy visits per year and stuff like that. We were advised to apply for a state insurance for children, so that we had something to cover whatever our primary insurance might not cover. It wasn't Medicaid, but similar, through a state program called Healthy Start. It is a good thing we had this secondary insurance, because at the end of 2007, my husband's group insurance was phased out, requiring us to purchase an individual insurance plan. The new plan would not cover because of his "pre-existing condition." So, now the state insurance is paying for all 's medical and therapy needs. I think he can be on this until he is 18. We did apply for another safety net type of insurance called BCMH (Bureau for Children with Medical Handicaps). I thought someone told us that BCMH is required by law to cover a child with a medical condition, if you qualify financially. I assumed this was a national program, but when I Google it, it comes up as a program of our state (Ohio). There should be a program like this in every state! Although I don't even really like the state of OH (my heart is in the WV mountains), I guess I should be really grateful for how they take care of our special needs kids!

Blessings!

Bolduc <jhunter5431charter (DOT) net> wrote:

I just heard on the news that the president candidates want to make sure that autism is not considered a pre-existing condition and that insurance has to pay for therapies.

I have 2 daughters with Trisomy 10q/5p and Trisomy 21/MDS. They are considered pre-existing and the insurance company will not pay for therapies, medical equipment or anything that will help them.

Isn't this discrimination against my kids and your kids? I know some of you have written that your child has dual diagnosis with autism. How will they handle that? Example: Your child was born with DS and years later diagnosised with autism. Will the insurance then cover everything or just the autism portion?

Hope I didn't start anything here but I am upset as I think all kiddos with any type of disabilities should be covered and get the therapies they need and get rid of the pre-existing condition clause for them. They did not ask to be born with their conditions and how can it be pre-existing when you find out after birth?

Proud mom to Jezeca, 5, Trisomy 10q/5p

& Zephany, 22 months, Trisomy 21/MDS?

You rock. That's why Blockbuster's offering you one month of Blockbuster Total Access, No Cost.

[Guest guest]

My DH's insurance through work.. both United health care and Anthem BlueCross.. have been OK with 's DS.

Depending on which one - some covered orthotics.. some did not.. UHC has been OK, but they have not been fond of ST. On the other hand they have covered most everything else. But when we switched Insurance.. they both had extensive paper work on Sam.. to Rule out Pre existing.. ( for myself too.. I have some thyroid stuff) they wanted to make sure we had had insurance with in the 90 days or what ever the limit is. They were trying to get out of it in my opinion.

My Mentor family ( has a son with DS ) has had tons of trouble getting covered. Their son was born 24 hours before the husbands insurance started with the new job.. and they called the boy's DS a pre existing. HE is only 3 months old and they will not cover anything down's related. Fortunately his heart was ok.. but the family paid for that scan out of pocket.

I think this pre existing stuff should be against the law myself.

Steph

Re: [DownSyndromeInfoExchange] Pre-existing condition

Our group health insurance through my husband's employer does not consider DS a pre-existing condition. However, there is only $1000 each for OT and speech per year. But I think a lot of insurance is like that. They have covered endocrinologist, cardiologist, ent, orthopedist, podiatrist, ped. Of course she is not seeing these docs for diagnosis DS. Her diagnosis for speech is apraxia and for OT it is low muscle tone and SID.

What is it that your insurance isn't covering because of pre-existing condition? Do they cover that same service for other diagnosis? You may be able to fight this discrimination.

ette

mom to Faith (10)DS

-------------- Original message from " Bolduc" : --------------

I just heard on the news that the president candidates want to make sure that autism is not considered a pre-existing condition and that insurance has to pay for therapies.

I have 2 daughters with Trisomy 10q/5p and Trisomy 21/MDS. They are considered pre-existing and the insurance company will not pay for therapies, medical equipment or anything that will help them.

Isn't this discrimination against my kids and your kids? I know some of you have written that your child has dual diagnosis with autism. How will they handle that? Example: Your child was born with DS and years later diagnosised with autism. Will the insurance then cover everything or just the autism portion?

Hope I didn't start anything here but I am upset as I think all kiddos with any type of disabilities should be covered and get the therapies they need and get rid of the pre-existing condition clause for them. They did not ask to be born with their conditions and how can it be pre-existing when you find out after birth?

Proud mom to Jezeca, 5, Trisomy 10q/5p

& Zephany, 22 months, Trisomy 21/MDS?

[Guest guest]

In Kansas, If you ahve group insurance and you switch jobs or group

insurance... they can not get you for pre-exsisting conditions.

My husband worked full time and we had his insurance. Then I finished

nursing school and got a fulltime job with group insurance. WHen he quit to

finish school, everyone was still covered.

On Sat, 5 Apr 2008 23:49:43 -0400, " Carlson "

wrote:

> My DH's insurance through work.. both United health care and Anthem

> BlueCross.. have been OK with 's DS.

> Depending on which one - some covered orthotics.. some did not.. UHC has

> been OK, but they have not been fond of ST. On the other hand they have

> covered most everything else. But when we switched Insurance.. they both

> had extensive paper work on Sam.. to Rule out Pre existing.. ( for myself

> too.. I have some thyroid stuff) they wanted to make sure we had had

> insurance with in the 90 days or what ever the limit is. They were trying

> to get out of it in my opinion.

>

> My Mentor family ( has a son with DS ) has had tons of trouble getting

> covered. Their son was born 24 hours before the husbands insurance

started

> with the new job.. and they called the boy's DS a pre existing. HE is

only

> 3 months old and they will not cover anything down's related.

Fortunately

> his heart was ok.. but the family paid for that scan out of pocket.

>

> I think this pre existing stuff should be against the law myself.

> Steph

> Re: [DownSyndromeInfoExchange] Pre-existing condition

>

>

> Our group health insurance through my husband's employer does not

> consider DS a pre-existing condition. However, there is only $1000 each

> for OT and speech per year. But I think a lot of insurance is like that.

> They have covered endocrinologist, cardiologist, ent, orthopedist,

> podiatrist, ped. Of course she is not seeing these docs for diagnosis DS.

> Her diagnosis for speech is apraxia and for OT it is low muscle tone and

> SID.

> What is it that your insurance isn't covering because of pre-existing

> condition? Do they cover that same service for other diagnosis? You may

be

> able to fight this discrimination.

> ette

> mom to Faith (10)DS

> -------------- Original message from " Bolduc "

> : -----------

[Guest guest]

Those in the ASD community really have their act together regarding advocacy for their kids!! Our large advocacy groups really are missing the boat here..... I won't repeat what everyone else has said regarding insurance benefits, but I do want to encourage you to find a social security advocate in your area. These people are well trained in how to get services for everyone, regardless of your income. I think they would be WELL worth the initial financial out put for their expertise. The system very purposely makes it almost impossible for the average person to break the code and get services. Carol in IL AIM doihavtasay1 GigaTribe doihavtasayMom to seven including , 7 with TOF, AVcanal, GERD, LS, Asthma, subglottal stenosis, and DS.My problem is not how I look. It's how you see me. Join our Down Syndrome information group - http://health.groups.yahoo.com/group/DownSyndromeInfoExchange/ Listen to oldest dd's music http://www.myspace.com/vennamusic

You rock. That's why Blockbuster's offering you one month of Blockbuster Total Access, No Cost.