Re: Insurance coverage question

[Guest guest]

Hi Cheryl:

We have BCBS and they did cover ST for my son who is now 3, unlimited

sessions, with a dx of oral apraxia. Now that he is 3, the school is

providing 2 hours of individual speech therapy, but this was a little

bit of a fight. I do not think a child with apraxia can improve with

just group therapy, in fact, I'm not sure how much your child will

get from a group, unless others in the group are at a similar stage

of speech development. I would push the school to provide individual

speech sessions with your child. Our school did not have an SLP to

provide services, but since they are obligated to, they are paying

for the 2 hours by contracting with a private SLP. We go to her

office 2 days a week, and she is great! Don't give up, push for what

your child needs.

Holly

>

> Some of you may remember me posting about my son and

> his " developmental language disorder. " I am fairly certain that he

> has some form of apraxia. My gut tells me it's verbal apraxia, but

> I'm no SLP. We are planning on setting up an evaluation with an

SLP

> who can diagnose him or at least give us a better idea of what is

the

> best way to help him. I was looking over our insurance coverage

and

> am feeling really annoyed!! Apparently, speech therapy is covered,

> up to 60 visits, so long as your child has a condition that can be

> improved as a result of the therapy. However, conditions that are

> normally serviced by our local school district are excluded. Both

> autism and apraxia/dyspraxia fall under that category. It's so

> frustrating! does receive two hours of service per week in a

> group setting. The only reason it's two hours instead of one is

> because they originally considered him to have a cognitive delay.

If

> he does end up getting an apraxia diagnosis, would two hours of

group

> therapy/week really be enough to " improve his condition " ? Does the

> school district really provide enough service for these little

ones?

> How can they when there are so many kids and still so little

> funding?

>

> Does anyone have insurance coverage for their child's speech

> therapy? If so, who is your carrier? I do realize coverage varies

> from state to state. I'm sure i've missed a link or site somewhere

> where this info would be available. My son may not even have

> apraxia... though I'm almost certain that he does... but it just

> annoys me to no end that the insurance would exclude that diagnosis

> from coverage. It just doesn't make sense to me.

>

[Guest guest]

Thanks Holly!

Our insurance is up for re-election soon and I know BCBS is an option.

We will have to look into that. It does make me feel better knowing

that you had unlimited coverage. My son will be 3 in October and

because his birthday falls before Dec. 1, he will transition out of our

Intermediate school districts EI program and into our school district's

special ed/ECDD program. Our ISD doesn't diagnosis, but hopefully when

transfers they will provide more individual therapy. We have an

appointment tuesday with our ped and I'm hoping she will refer me to an

SLP or a developmental ped so we can get a diagnosis.

> >

> > Some of you may remember me posting about my son and

> > his " developmental language disorder. " I am fairly certain that he

> > has some form of apraxia. My gut tells me it's verbal apraxia, but

> > I'm no SLP. We are planning on setting up an evaluation with an

> SLP

> > who can diagnose him or at least give us a better idea of what is

> the

> > best way to help him. I was looking over our insurance coverage

> and

> > am feeling really annoyed!! Apparently, speech therapy is covered,

> > up to 60 visits, so long as your child has a condition that can be

> > improved as a result of the therapy. However, conditions that are

> > normally serviced by our local school district are excluded. Both

> > autism and apraxia/dyspraxia fall under that category. It's so

> > frustrating! does receive two hours of service per week in a

> > group setting. The only reason it's two hours instead of one is

> > because they originally considered him to have a cognitive delay.

> If

> > he does end up getting an apraxia diagnosis, would two hours of

> group

> > therapy/week really be enough to " improve his condition " ? Does the

> > school district really provide enough service for these little

> ones?

> > How can they when there are so many kids and still so little

> > funding?

> >

> > Does anyone have insurance coverage for their child's speech

> > therapy? If so, who is your carrier? I do realize coverage varies

> > from state to state. I'm sure i've missed a link or site somewhere

> > where this info would be available. My son may not even have

> > apraxia... though I'm almost certain that he does... but it just

> > annoys me to no end that the insurance would exclude that diagnosis

> > from coverage. It just doesn't make sense to me.

> >

>

[Guest guest]

It is so hard also to get insurance if your child has Apraxia and PDD NOS

which is on the Autism spectrum. Any mention of the PDD NOS and you usually

get turned down, very sad.

**************Ideas to please picky eaters. Watch video on AOL Living.

(http://living.aol.com/video/how-to-please-your-picky-eater/rachel-campos-duffy/

2050827?NCID=aolcmp00300000002598)

[Guest guest]

FYI - All policies differ, so be sure you ask or see the coverage

language before choosing. For instance, we have BCBS too, but our

coverage excludes speech therapy for anything deemed developmental

as opposed to caused by or arising from an accident or injury. :-(

Even then, coverage is limited to 20 sessions a year.

> > >

> > > Some of you may remember me posting about my son and

> > > his " developmental language disorder. " I am fairly certain

that he

> > > has some form of apraxia. My gut tells me it's verbal apraxia,

but

> > > I'm no SLP. We are planning on setting up an evaluation with an

> > SLP

> > > who can diagnose him or at least give us a better idea of what

is

> > the

> > > best way to help him. I was looking over our insurance coverage

> > and

> > > am feeling really annoyed!! Apparently, speech therapy is

covered,

> > > up to 60 visits, so long as your child has a condition that

can be

> > > improved as a result of the therapy. However, conditions that

are

> > > normally serviced by our local school district are excluded.

Both

> > > autism and apraxia/dyspraxia fall under that category. It's so

> > > frustrating! does receive two hours of service per week

in a

> > > group setting. The only reason it's two hours instead of one is

> > > because they originally considered him to have a cognitive

delay.

> > If

> > > he does end up getting an apraxia diagnosis, would two hours of

> > group

> > > therapy/week really be enough to " improve his condition " ? Does

the

> > > school district really provide enough service for these little

> > ones?

> > > How can they when there are so many kids and still so little

> > > funding?

> > >

> > > Does anyone have insurance coverage for their child's speech

> > > therapy? If so, who is your carrier? I do realize coverage

varies

> > > from state to state. I'm sure i've missed a link or site

somewhere

> > > where this info would be available. My son may not even have

> > > apraxia... though I'm almost certain that he does... but it

just

> > > annoys me to no end that the insurance would exclude that

diagnosis

> > > from coverage. It just doesn't make sense to me.

> > >

> >

>

[Guest guest]

Hi Asma,

There is a group called autism_insurance_information that might be a good

resource for comparing insurance companies. I'm not quite so sure about the

squeeze thing that will feel like hands or feet, but you might try one of the

companies that specializes in sensory aids. Good luck!

Bridget

>

> hi. My son is 3 1/2 and he is on the spectrum and spd since only a few months

ago. I have been reading a lot of posts and am surprised at the amount of

advice and help this group provides. It seems like my son has Asperger's but I

don't know why they just tell me that it's high functioning autism. It is

really nice to know that i am not alone out there trying to figure out what to

do for every single situation with my son. I had a few questions for everyone:

>

> 1. is there one company that provides better coverage for therapies for

autistic kids? i live in new jersey and have oxford/united but they only allow

30 sessions each for o.t. and speech annually and considering speech is only 30

minutes, it's just not enough time. I will run out of sessions in about 7

months. Through my husband's work, i can choose for a few major companies for

medical insurance and i would love it if i could get more for my son.

>

> 2. My son loves to squeeze with his hands but he won't squeeze things. He

will squeeze my arm or my 1 year old daughter's feet/hands. He used to go for

the neck from the back but we've finally gotten him to stop that. When he

sleeps, he also likes his feet/hands underneath my body. Weighted blankets

won't work because he hates blankets. he jumps on a trampoline a lot. is there

anything else i can use to maybe put on his feet or to give that extra pressure

under his feet? or ( i know i'm really pushing it here) but is there anything

that feels like you're squeezing a human hand/feet?

>

> I would really appreciate all of your input/advice. Thank you.

>

> Asma

>

[Guest guest]

I am not sure about the weighted product, but are you sure the insurance says only 30 sessions per year?? Mine states 18 per year but will review the situation and can authorize more....

Carolyn

From: jazbaati82 <asmavayani@...> Sent: Mon, March 7, 2011 9:03:38 AMSubject: ( ) Insurance Coverage Question

hi. My son is 3 1/2 and he is on the spectrum and spd since only a few months ago. I have been reading a lot of posts and am surprised at the amount of advice and help this group provides. It seems like my son has Asperger's but I don't know why they just tell me that it's high functioning autism. It is really nice to know that i am not alone out there trying to figure out what to do for every single situation with my son. I had a few questions for everyone:1. is there one company that provides better coverage for therapies for autistic kids? i live in new jersey and have oxford/united but they only allow 30 sessions each for o.t. and speech annually and considering speech is only 30 minutes, it's just not enough time. I will run out of sessions in about 7 months. Through my husband's work, i can choose for a few major companies for medical insurance and i would love it if i could get more for my son.2. My son loves to squeeze with his

hands but he won't squeeze things. He will squeeze my arm or my 1 year old daughter's feet/hands. He used to go for the neck from the back but we've finally gotten him to stop that. When he sleeps, he also likes his feet/hands underneath my body. Weighted blankets won't work because he hates blankets. he jumps on a trampoline a lot. is there anything else i can use to maybe put on his feet or to give that extra pressure under his feet? or ( i know i'm really pushing it here) but is there anything that feels like you're squeezing a human hand/feet?I would really appreciate all of your input/advice. Thank you.Asma

[Guest guest]

my son was the same way, we used ankle weights for him, just small womens 5 pounds total, i think they were 2.5 pounds each. they tend to fall on the top of the arch and it felt good. he still pushes his feet under you if you are sitting on the couch next to him or if he crawls into bed with me, his feet go right under me. the crazy thing is, he hates wearing shoes! Sycamore Art StudiosSycamore Art SchoolDeborah GustlinGraphic & Web

DesignArt classes for K-12www.sycamoreartstudios.comwww.sycamoreartschool.comHome: 408-710-0892 Business: 408-710-6070From: bridget <beanniferj@...> Sent: Mon, March 7, 2011 11:03:24 AMSubject: ( ) Re: Insurance Coverage Question

Hi Asma,

There is a group called autism_insurance_information that might be a good resource for comparing insurance companies. I'm not quite so sure about the squeeze thing that will feel like hands or feet, but you might try one of the companies that specializes in sensory aids. Good luck!

Bridget

>

> hi. My son is 3 1/2 and he is on the spectrum and spd since only a few months ago. I have been reading a lot of posts and am surprised at the amount of advice and help this group provides. It seems like my son has Asperger's but I don't know why they just tell me that it's high functioning autism. It is really nice to know that i am not alone out there trying to figure out what to do for every single situation with my son. I had a few questions for everyone:

>

> 1. is there one company that provides better coverage for therapies for autistic kids? i live in new jersey and have oxford/united but they only allow 30 sessions each for o.t. and speech annually and considering speech is only 30 minutes, it's just not enough time. I will run out of sessions in about 7 months. Through my husband's work, i can choose for a few major companies for medical insurance and i would love it if i could get more for my son.

>

> 2. My son loves to squeeze with his hands but he won't squeeze things. He will squeeze my arm or my 1 year old daughter's feet/hands. He used to go for the neck from the back but we've finally gotten him to stop that. When he sleeps, he also likes his feet/hands underneath my body. Weighted blankets won't work because he hates blankets. he jumps on a trampoline a lot. is there anything else i can use to maybe put on his feet or to give that extra pressure under his feet? or ( i know i'm really pushing it here) but is there anything that feels like you're squeezing a human hand/feet?

>

> I would really appreciate all of your input/advice. Thank you.

>

> Asma

>

[Guest guest]

If you have a diagnosis of autism the school district can get

involved right now and provide any services he needs

like OT or speech and he is eligible for special needs

preschool.

If there are any speech delays they call it HFA rather than AS.

In NJ, insurance companies have to pay for behavior therapy too. This

would be under mental health. You get a certified

behaviorist, you can get a list from austim NJ. You will

find advocates and all kind of help from this group.

My daughter is 13 and she is still biting my hand from time

to time, or raking my hair with her hands. These are calming

strategies and when anxiety is better under control they

are reduced.

I didn't really pay attention to the fact that it takes

my daughter an hour or more to fall asleep. She never

seemed to look sleepy. As she got older she got way more

irritable at night.

I read on the Mayo Clinic website that 70% kids with ASD have a sleep latency

issue and the Mayo Clinic recommends that ASD

take 3mg of melatonin to help address this issue. My daughter

is asleep within 30 minutes on 2 mg and no more issues

with her feet and having them restless and wanting weight

on it and no more increased compulsions at night. GNC

has melatonin that is cherry favored and dissolves in the

mouth (1 mg).

Hope this is of some help. I live in NJ too.

Pam

>

> hi. My son is 3 1/2 and he is on the spectrum and spd since only a few months

ago. I have been reading a lot of posts and am surprised at the amount of

advice and help this group provides. It seems like my son has Asperger's but I

don't know why they just tell me that it's high functioning autism. It is

really nice to know that i am not alone out there trying to figure out what to

do for every single situation with my son. I had a few questions for everyone:

>

> 1. is there one company that provides better coverage for therapies for

autistic kids? i live in new jersey and have oxford/united but they only allow

30 sessions each for o.t. and speech annually and considering speech is only 30

minutes, it's just not enough time. I will run out of sessions in about 7

months. Through my husband's work, i can choose for a few major companies for

medical insurance and i would love it if i could get more for my son.

>

> 2. My son loves to squeeze with his hands but he won't squeeze things. He

will squeeze my arm or my 1 year old daughter's feet/hands. He used to go for

the neck from the back but we've finally gotten him to stop that. When he

sleeps, he also likes his feet/hands underneath my body. Weighted blankets

won't work because he hates blankets. he jumps on a trampoline a lot. is there

anything else i can use to maybe put on his feet or to give that extra pressure

under his feet? or ( i know i'm really pushing it here) but is there anything

that feels like you're squeezing a human hand/feet?

>

> I would really appreciate all of your input/advice. Thank you.

>

> Asma

>

[Guest guest]

I'm not sure I can help with either question. But I wanted to ask if your state offers early intervention programs or if you live near a research hospital? The research hospital near us offers a lot of free services if you agree to participate in studies. Not sure if this is a possibility for you. Just a thought. Good luck!ne

From: Deborah Gustlin <sycamorestudios@...>Subject: Re: ( ) Re: Insurance Coverage Question Date: Monday, March 7, 2011, 2:24 PM

my son was the same way, we used ankle weights for him, just small womens 5 pounds total, i think they were 2.5 pounds each. they tend to fall on the top of the arch and it felt good. he still pushes his feet under you if you are sitting on the couch next to him or if he crawls into bed with me, his feet go right under me. the crazy thing is, he hates wearing shoes!

Sycamore Art StudiosSycamore Art SchoolDeborah GustlinGraphic & Web DesignArt classes for K-12www.sycamoreartstudios.comwww.sycamoreartschool.comHome: 408-710-0892 Business:

408-710-6070

From: bridget <beanniferj@...> Sent: Mon, March 7, 2011 11:03:24 AMSubject: ( ) Re: Insurance Coverage Question

Hi Asma,There is a group called autism_insurance_information that might be a good resource for comparing insurance companies. I'm not quite so sure about the squeeze thing that will feel like hands or feet, but you might try one of the companies that specializes in sensory aids. Good luck!Bridget>> hi. My son is 3 1/2 and he is on the spectrum and spd since only a few months ago. I have been reading a lot of posts and am surprised at the amount of advice and help this group provides. It seems like my son has Asperger's but I don't know why they just tell me that it's high functioning autism. It is really nice to know that i am not alone out there trying

to figure out what to do for every single situation with my son. I had a few questions for everyone:> > 1. is there one company that provides better coverage for therapies for autistic kids? i live in new jersey and have oxford/united but they only allow 30 sessions each for o.t. and speech annually and considering speech is only 30 minutes, it's just not enough time. I will run out of sessions in about 7 months. Through my husband's work, i can choose for a few major companies for medical insurance and i would love it if i could get more for my son.> > 2. My son loves to squeeze with his hands but he won't squeeze things. He will squeeze my arm or my 1 year old daughter's feet/hands. He used to go for the neck from the back but we've finally gotten him to stop that. When he sleeps, he also likes his feet/hands underneath my body. Weighted blankets won't work because he hates blankets. he jumps on a trampoline a lot. is there

anything else i can use to maybe put on his feet or to give that extra pressure under his feet? or ( i know i'm really pushing it here) but is there anything that feels like you're squeezing a human hand/feet?> > I would really appreciate all of your input/advice. Thank you.> > Asma>