Expenses for different type of treatments for PDD kid

[Guest guest]

Hi All,

I'm trying to find out how much will the following type of therapies might cost

us in the Philadelphia area, so if someone have at least rough estimations and

is there some type of insurance coverage for the special needs therapies.

Not all treatments are correctly translated as I'm trying translate it from our

local treatments here in Israel.

1) Occupational therapy

2) Speech therapy

3) Child psychologist

4) Art therapy

Any information on the prices for these types of therapies and whether or not it

is covered by insurance ( a private one ) would be highly appreciate it.

thank you so much.

[Guest guest]

Probably around $100 an hour for OT and speech. And there are no affordable

private insurances that covers these. If I am wrong someone please let me know.

Sent from my iPhone

On Mar 12, 2011, at 2:59 PM, " galblank " <galblank@...> wrote:

> Hi All,

> I'm trying to find out how much will the following type of therapies might

cost us in the Philadelphia area, so if someone have at least rough estimations

and is there some type of insurance coverage for the special needs therapies.

> Not all treatments are correctly translated as I'm trying translate it from

our local treatments here in Israel.

> 1) Occupational therapy

> 2) Speech therapy

> 3) Child psychologist

> 4) Art therapy

> Any information on the prices for these types of therapies and whether or not

it is covered by insurance ( a private one ) would be highly appreciate it.

>

> thank you so much.

>

>

[Guest guest]

If your child is in school, the school is required to provide OT and speech

therapy if the child needs it, at no cost to you. Most private insurance will

usually cover 12 visits per year of OT, speech, and psychologist. Some

insurances have a lifetime cap.

If you need more (for instance, weekly ongoing OT) you can request a Medicaid

disability waiver. That means you are asking Medicaid to consider your child's

disability, not your income, and give you public health care. Depending on the

state, this can be either a 3month wait or near impossible. I'm not sure about

Penn, so call Penn Medicaid and ask about disability waivers.

You can also try the Dept. of Public Health. Again, it depends on the state, but

most have specific programs for autism spectrum disorders (but they depend on

you allowing your child to be labeled ASD to qualify for the service.)

Don't listen to people who say there is no way to get therapy except pay

$100/hr. There is always a way, but it takes research and persistence. Good

luck.

Dawn

>

> Hi All,

> I'm trying to find out how much will the following type of therapies might

cost us in the Philadelphia area, so if someone have at least rough estimations

and is there some type of insurance coverage for the special needs therapies.

> Not all treatments are correctly translated as I'm trying translate it from

our local treatments here in Israel.

> 1) Occupational therapy

> 2) Speech therapy

> 3) Child psychologist

> 4) Art therapy

> Any information on the prices for these types of therapies and whether or not

it is covered by insurance ( a private one ) would be highly appreciate it.

>

> thank you so much.

>

[Guest guest]

I can't offer info about the Philadelphia area but our insurance companies

have always paid for speech, occupational therapy and a psychologist

visit. Over the years, we found that using a medical diagnosis code for

therapies and the autism diagnosis code for psychologist visits paid much

better.

Don't let the therapist put the autism code on anything you submit as a

" medical " treatment though because the insurance companies will use that to

kick it out. We always used the toxic encephalopathy diagnosis for my son

but I imagine some sort of code about the problem being due to the after

effects of a virus with a note from the doctor would work as well.

Gaylen

In a message dated 3/13/2011 4:18:26 P.M. Central Daylight Time,

rogerbruneau@... writes:

Probably around $100 an hour for OT and speech. And there are no affordable

private insurances that covers these. If I am wrong someone please let me

know.

Sent from my iPhone

On Mar 12, 2011, at 2:59 PM, " galblank " <_galblank@..._

(mailto:galblank@...) > wrote:

> Hi All,

> I'm trying to find out how much will the following type of therapies

might cost us in the Philadelphia area, so if someone have at least rough

estimations and is there some type of insurance coverage for the special needs

therapies.

> Not all treatments are correctly translated as I'm trying translate it

from our local treatments here in Israel.

> 1) Occupational therapy

> 2) Speech therapy

> 3) Child psychologist

> 4) Art therapy

> Any information on the prices for these types of therapies and whether

or not it is covered by insurance ( a private one ) would be highly

appreciate it.

>

> thank you so much.

>

>

[Non-text portions of this message have been removed]

[Guest guest]

We are in Philadelphia area, a little out of the city and the counties

provide services, so I'm not sure how much each costs. They are all

different though b/c I did a while back looks into costs, but it totally

depends on your insurance. I know that's not helpful, but if you move here,

you'd have your child evaluated and you would probably be approved for

county services, which provide all the disciplines below. Then you'd have no

cost. If you wanted additional therapies, you'd have to ask your insurance

what they'd cover. If they didn't cover anything, you'd have to call

around. I have to say, depending on the agencies, the costs really vary.

For example, speech can be anywhere for 60 an hour to close to 100, depends

on the therapist.

kathi

From: [mailto: ] On Behalf Of

galblank

Sent: Saturday, March 12, 2011 2:59 PM

Subject: Expenses for different type of treatments for PDD kid

Hi All,

I'm trying to find out how much will the following type of therapies might

cost us in the Philadelphia area, so if someone have at least rough

estimations and is there some type of insurance coverage for the special

needs therapies.

Not all treatments are correctly translated as I'm trying translate it from

our local treatments here in Israel.

1) Occupational therapy

2) Speech therapy

3) Child psychologist

4) Art therapy

Any information on the prices for these types of therapies and whether or

not it is covered by insurance ( a private one ) would be highly appreciate

it.

thank you so much.

[Guest guest]

Not saying she won't get OT for her child, but if she is shopping for private

insurance and her child has a pre-existing condition it will be expensive If I

am wrong someone please tell me the carrier so I can apply. Our son has gotten

OT through the county in the past and speech for 3 years. Good luck.

Sent from my iPhone

On Mar 13, 2011, at 9:56 PM, " dynamom05 " <dawnmchappell@...> wrote:

> If your child is in school, the school is required to provide OT and speech

therapy if the child needs it, at no cost to you. Most private insurance will

usually cover 12 visits per year of OT, speech, and psychologist. Some

insurances have a lifetime cap.

>

> If you need more (for instance, weekly ongoing OT) you can request a Medicaid

disability waiver. That means you are asking Medicaid to consider your child's

disability, not your income, and give you public health care. Depending on the

state, this can be either a 3month wait or near impossible. I'm not sure about

Penn, so call Penn Medicaid and ask about disability waivers.

>

> You can also try the Dept. of Public Health. Again, it depends on the state,

but most have specific programs for autism spectrum disorders (but they depend

on you allowing your child to be labeled ASD to qualify for the service.)

>

> Don't listen to people who say there is no way to get therapy except pay

$100/hr. There is always a way, but it takes research and persistence. Good

luck.

> Dawn

>

>

> >

> > Hi All,

> > I'm trying to find out how much will the following type of therapies might

cost us in the Philadelphia area, so if someone have at least rough estimations

and is there some type of insurance coverage for the special needs therapies.

> > Not all treatments are correctly translated as I'm trying translate it from

our local treatments here in Israel.

> > 1) Occupational therapy

> > 2) Speech therapy

> > 3) Child psychologist

> > 4) Art therapy

> > Any information on the prices for these types of therapies and whether or

not it is covered by insurance ( a private one ) would be highly appreciate it.

> >

> > thank you so much.

> >

>

>

[Guest guest]

In Alabama, the cost of OT & Speech range from $50-$70+ per half hour (more

expensive at Children's Hospitals, less expensive at small groups w/experience

w/autism).  Psychologists here average $130-$140 per psychologist hour (40-50

minutes).  I have no idea about art therapy. 

Community Mental Health centers tend to have lower costs for someone who does

not have insurance, but are usually rather overcrowded and can take longer to

get in. 

I would contact the local Autism Society for that area, ask for their local

email group to talk to parents in the area about providers and their cost.

Do you already have the private insurance?  If not, at least in Alabama, most

of

our private insurance policies (not purchased through a group/company) have

a 1

year waiting period on pre-existing .  Not sure if the same would apply in

Philly - different states have different coverage requirements.  Coverage for

speech & OT also tend to vary widely - first based on the type of policy

(private or group, major medical or comprehensive health plan), and then just

depends on the insurance company and their basic coverages.  A lot of times

they

may place restrictions for which diagnosis they would cover speech or OT for. 

Most policies will put a maximum # of visits or max $ amount on speech & OT. 

In

Alabama, the most common limit I see is 30 visits combined w/speech, OT, and

physical therapy, although there are policies without limits too.  You should

be

able to get clear information before signing up for a policy, and if you already

have one, get detailed benefits.  Sometimes the cost difference of the premium

of a policy that does cover speech and OT does not pay for itself when there are

limits - it sometimes costs less to pay out of pocket in the long run.  If you

ever need help calculating that, contact me  & I can help.

Mental health guidelines are starting to change in a lot of places and is lining

up to match the medical coverage, so that may not be to bad.

________________________________

From: galblank <galblank@...>

Sent: Sat, March 12, 2011 1:59:21 PM

Subject: Expenses for different type of treatments for PDD kid

 

Hi All,

I'm trying to find out how much will the following type of therapies might cost

us in the Philadelphia area, so if someone have at least rough estimations and

is there some type of insurance coverage for the special needs therapies.

Not all treatments are correctly translated as I'm trying translate it from our

local treatments here in Israel.

1) Occupational therapy

2) Speech therapy

3) Child psychologist

4) Art therapy

Any information on the prices for these types of therapies and whether or not it

is covered by insurance ( a private one ) would be highly appreciate it.

thank you so much.

[Guest guest]

Ok guys, thank you for all your answers and input, here is some more info

that just came in.

I'm getting at Aetna insurance from the employer for me and my family.

I'm still going over these 20 pages of info from the insurance but I saw

something that doesn't make much sense to me and I need your help to figure

it out.

Basically what it says that the insurance covers 30 visits to Occupational

therapy and Speech Therapy per YEAR?! Is that possible?

Right now we have 3 times a week occupational therapy 3 times a week speech

therapy and 3 times a week child psychologist including coverage for a Floor

Time therapy.

Is the Aetna make sense to you guys?

thanks

[Guest guest]

Private OT/PT/Speech $110/hour Glen Mills, $135/hour Marlton, NJ

NJ is broke. You will need an attorney to get what you need if your kid is

really severe and you are in NJ and have to deal with a school district. But,

if you have the money to move to somewhere like stown or Voorhees, NJ you

might get the school district to pay for more. It is a tradeoff. In PA, the

kids have insurance from the state, but a really uncertain future after age 21.

In NJ, no state insurance, everything is the school district, but there's better

adult services. South Jersey is a suburb of Philadelphia.

Some insurance will pay you back for private. Some do not.

>

> We are in Philadelphia area, a little out of the city and the counties

> provide services, so I'm not sure how much each costs. They are all

> different though b/c I did a while back looks into costs, but it totally

> depends on your insurance. I know that's not helpful, but if you move here,

> you'd have your child evaluated and you would probably be approved for

> county services, which provide all the disciplines below. Then you'd have no

> cost. If you wanted additional therapies, you'd have to ask your insurance

> what they'd cover. If they didn't cover anything, you'd have to call

> around. I have to say, depending on the agencies, the costs really vary.

> For example, speech can be anywhere for 60 an hour to close to 100, depends

> on the therapist.

>

> kathi

>

>

>

> From: [mailto: ] On Behalf Of

> galblank

> Sent: Saturday, March 12, 2011 2:59 PM

>

> Subject: Expenses for different type of treatments for PDD kid

>

>

>

>

>

> Hi All,

> I'm trying to find out how much will the following type of therapies might

> cost us in the Philadelphia area, so if someone have at least rough

> estimations and is there some type of insurance coverage for the special

> needs therapies.

> Not all treatments are correctly translated as I'm trying translate it from

> our local treatments here in Israel.

> 1) Occupational therapy

> 2) Speech therapy

> 3) Child psychologist

> 4) Art therapy

> Any information on the prices for these types of therapies and whether or

> not it is covered by insurance ( a private one ) would be highly appreciate

> it.

>

> thank you so much.

>

>

>

>

>

>

[Guest guest]

We have AETNA and they cut us off 2 years ago for all OT and Speech so it does

not surprise me.  BTW we appealed and appealed and nothing.

 

From: Gal Blank <galblank@...>

Subject: Re: Expenses for different type of treatments for PDD kid

Date: Tuesday, March 15, 2011, 5:34 PM

 

Ok guys, thank you for all your answers and input, here is some more info

that just came in.

I'm getting at Aetna insurance from the employer for me and my family.

I'm still going over these 20 pages of info from the insurance but I saw

something that doesn't make much sense to me and I need your help to figure

it out.

Basically what it says that the insurance covers 30 visits to Occupational

therapy and Speech Therapy per YEAR?! Is that possible?

Right now we have 3 times a week occupational therapy 3 times a week speech

therapy and 3 times a week child psychologist including coverage for a Floor

Time therapy.

Is the Aetna make sense to you guys?

thanks

[Guest guest]

It¹s a restriction of your policy. You are lucky it is per year and not

lifetime as I have seen lifetime limits for therapy of 30.

If you are in CA you can use the AB88 law for self-funded (meaning the

employer purchases the plan and doesn¹t fund it) which states that insurance

companies cannot limit the amount of services for Mental Health and right

now Autism is mental health. I¹ve used this successfully with my carriers

and at the time it was Aetna (who paid for OT, Speech, and ABA no issues)

when the company was not renewing the contract and they decided not to pay

for speech. Once I wrote that letter it was a non-issue.

Laureen

On 3/16/11 3:52 PM, " Bruneau " <rogerbruneau@...> wrote:

>

>

>

>

>

> We have AETNA and they cut us off 2 years ago for all OT and Speech so it does

> not surprise me.  BTW we appealed and appealed and nothing.

>  

>

>

>

>

> From: Gal Blank <galblank@... <mailto:galblank%40gmail.com> >

> Subject: Re: Expenses for different type of treatments for PDD kid

> <mailto:%40>

> Date: Tuesday, March 15, 2011, 5:34 PM

>

>  

>

> Ok guys, thank you for all your answers and input, here is some more info

> that just came in.

> I'm getting at Aetna insurance from the employer for me and my family.

> I'm still going over these 20 pages of info from the insurance but I saw

> something that doesn't make much sense to me and I need your help to figure

> it out.

> Basically what it says that the insurance covers 30 visits to Occupational

> therapy and Speech Therapy per YEAR?! Is that possible?

> Right now we have 3 times a week occupational therapy 3 times a week speech

> therapy and 3 times a week child psychologist including coverage for a Floor

> Time therapy.

> Is the Aetna make sense to you guys?

>

> thanks

>

>

[Guest guest]

30 visits a year sounds great to me. We used to only get $500 per person a

fiscal year through our insurance with Sunlife! That is barely more then 4

visits at $110 an hour!

Lori

_____

From: [mailto: ] On Behalf Of Gal

Blank

Sent: March-15-11 5:35 PM

Subject: Re: Expenses for different type of treatments for PDD kid

Ok guys, thank you for all your answers and input, here is some more info

that just came in.

I'm getting at Aetna insurance from the employer for me and my family.

I'm still going over these 20 pages of info from the insurance but I saw

something that doesn't make much sense to me and I need your help to figure

it out.

Basically what it says that the insurance covers 30 visits to Occupational

therapy and Speech Therapy per YEAR?! Is that possible?

Right now we have 3 times a week occupational therapy 3 times a week speech

therapy and 3 times a week child psychologist including coverage for a Floor

Time therapy.

Is the Aetna make sense to you guys?

thanks

[Guest guest]

DO you know if our kid would get some OT/SP therapies from the school district?

and if yes,how much of those can he get?

I mean 30 visits per year with sounds way to little, it means that we can take

our son every 2 weeks to these therapies instead of what we have now which is

2-3 times a week, so I'm hoping the school district will add some once a week

sessions for him. Is that something that I can count on in Philadelphia?

thanks again.

>

> 30 visits a year sounds great to me. We used to only get $500 per person a

> fiscal year through our insurance with Sunlife! That is barely more then 4

> visits at $110 an hour!

>

>

>

> Lori

>

>

>

> _____

>

> From: [mailto: ] On Behalf Of Gal

> Blank

> Sent: March-15-11 5:35 PM

>

> Subject: Re: Expenses for different type of treatments for PDD kid

>

>

>

>

>

> Ok guys, thank you for all your answers and input, here is some more info

> that just came in.

> I'm getting at Aetna insurance from the employer for me and my family.

> I'm still going over these 20 pages of info from the insurance but I saw

> something that doesn't make much sense to me and I need your help to figure

> it out.

> Basically what it says that the insurance covers 30 visits to Occupational

> therapy and Speech Therapy per YEAR?! Is that possible?

> Right now we have 3 times a week occupational therapy 3 times a week speech

> therapy and 3 times a week child psychologist including coverage for a Floor

> Time therapy.

> Is the Aetna make sense to you guys?

>

> thanks

>

>

[Guest guest]

It depends on what the state of PA has allocated. School districts are bound by

state requirements. In order to gain treatment you need to go through the IEP

process to determine what your child will receive.

Sent from my iPhone

On Mar 17, 2011, at 9:12 AM, " galblank " <galblank@...> wrote:

> DO you know if our kid would get some OT/SP therapies from the school

district? and if yes,how much of those can he get?

> I mean 30 visits per year with sounds way to little, it means that we can take

our son every 2 weeks to these therapies instead of what we have now which is

2-3 times a week, so I'm hoping the school district will add some once a week

sessions for him. Is that something that I can count on in Philadelphia?

>

> thanks again.

>

>

> >

> > 30 visits a year sounds great to me. We used to only get $500 per person a

> > fiscal year through our insurance with Sunlife! That is barely more then 4

> > visits at $110 an hour!

> >

> >

> >

> > Lori

> >

> >

> >

> > _____

> >

> > From: [mailto: ] On Behalf Of Gal

> > Blank

> > Sent: March-15-11 5:35 PM

> >

> > Subject: Re: Expenses for different type of treatments for PDD kid

> >

> >

> >

> >

> >

> > Ok guys, thank you for all your answers and input, here is some more info

> > that just came in.

> > I'm getting at Aetna insurance from the employer for me and my family.

> > I'm still going over these 20 pages of info from the insurance but I saw

> > something that doesn't make much sense to me and I need your help to figure

> > it out.

> > Basically what it says that the insurance covers 30 visits to Occupational

> > therapy and Speech Therapy per YEAR?! Is that possible?

> > Right now we have 3 times a week occupational therapy 3 times a week speech

> > therapy and 3 times a week child psychologist including coverage for a Floor

> > Time therapy.

> > Is the Aetna make sense to you guys?

> >

> > thanks

> >

> >

[Guest guest]

Aetna's general policies are to cover short-term therapy from an immediate

illness or injury.  Then they evaluate how much measurable progress is being

made and is expected to be made, but at the 2 year mark, yes, I have seen them

cut off those services because they've moved into long-term therapy - simply not

covered.

I sometimes found it a miracle that they covered it that long.  They are

actually making exceptions due to progress when they let therapy go past about 9

months.  They were technically being kind of generous when they could have cut

off services based on their policies much earlier.

Watch out for other things with Aetna, too, like lifetime maximums that are too

easy to meet.  But they sure are one of the cheaper policies if you're

healthy... It is true insurance, not a healthcare plan.

HTH

________________________________

From: Bruneau <rogerbruneau@...>

Sent: Wed, March 16, 2011 6:52:35 PM

Subject: Re: Expenses for different type of treatments for PDD kid

 

We have AETNA and they cut us off 2 years ago for all OT and Speech so it does

not surprise me.  BTW we appealed and appealed and nothing.

 

From: Gal Blank <galblank@...>

Subject: Re: Expenses for different type of treatments for PDD kid

Date: Tuesday, March 15, 2011, 5:34 PM

 

Ok guys, thank you for all your answers and input, here is some more info

that just came in.

I'm getting at Aetna insurance from the employer for me and my family.

I'm still going over these 20 pages of info from the insurance but I saw

something that doesn't make much sense to me and I need your help to figure

it out.

Basically what it says that the insurance covers 30 visits to Occupational

therapy and Speech Therapy per YEAR?! Is that possible?

Right now we have 3 times a week occupational therapy 3 times a week speech

therapy and 3 times a week child psychologist including coverage for a Floor

Time therapy.

Is the Aetna make sense to you guys?

thanks