Insurance and Special Needs Children
Insurance Issues for Autistic and other Special Needs Children
Sep 11, 2009
Having your child go through multiple developmental evaluations is difficult and emotional for parents, and that upset and stress can get worse when parents unknowingly use services not covered by their insurance plan. This can lead to thousands of dollars in medical and therapy bills that can stress out even the best parents. Here are the things you need to know to protect yourself and your family.
What Insurance Carriers Don't Tell You
What the fine print might not clearly state is that if your child needs a specialist's evaluation for anything from ADHD to Autism that they may not cover the evaluation. Beyond that, they may cover the evaluation but not cover treatment once they receive a diagnostic code from your child's practitioner. Knowing what your insurance will or will not cover is something that will take a lot of work. However, this work is well worth the thousands of dollars you may save by knowing what you can and cannot do.
How to Get Around Insurance Coverage
After you have done your research with your particular insurance carrier, find a specialist that takes your particular form of insurance. Also, when shopping around for a specialist, make sure that you find a doctor that is willing to work with you to provide the specific diagnostic codes that your insurance carrier accepts for specific treatment. This may mean that your child has a certain type of delay or disorder that is slightly different from the code put down in the charts so that your insurance is still covering for the treatment since the treatment for both is the same. Also, make sure if your child needs any medications that your doctor is willing to prescribe medications that are covered by your insurance as well. Medication costs can add up very quickly, particularly if your child has many different conditions.
What to Do if Your Insurance Doesn't Cover Payments
Your insurance plan may just not cover certain things. Also, you may be concerned about your child receiving a medical diagnosis because of the potential refusal of insurance coverage in the future due to "preexisting conditions." Although this is not a reason to avoid seeking assistance, something to consider is free programs such as Early Start Programs. These programs are usually run by the local school districts and may vary in name from place to place. They often provide free intervention services for children with developmental delays or disorders and often have programs for infants and toddlers as well. These kinds of programs can give you access to therapy and support groups as well as other social interactions with other children and parents. Also, these programs are great for getting your child set up with an IEP (individualized Education Plan) so that any disabilities or disorders your child has will be accommodated in school or day-care.
Ultimately, you need to research your options and look at what is available for your child in a wide variety of places. Depending on your child's illness, disorder, or disability, there may be a number of free or reduced-cost resources to assist you in providing therapy and care to your child. Don't be afraid to reach out and take advantage of all resources available to you so that you and your child can have the best potential future.
