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Anyone else have a child with challenges that just never seem to end?

Now my son's insurance is telling me that he can no longer have the therapy he needs. Are you kidding? Talk about appeals and all that fun jazz. Anyone else ever had to do this?
Also am now taking my son monday to talk to his ped. about the insurance issues and also to have him checked for problems with his spine curving.... I'm hoping its nothing and the funny things i see are just because he is hypotonic and his muscles are just letting things move more than normal..........

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Asked by nrfountain at 3:13 PM on Oct. 6, 2010 in Kids' Health

Level 4 (49 Credits)
Answers (7)
  • The first 10 years of my daughter's life were spent with every kind of specialist under the sun and at weekly physical therapy sessions and I spent way too many houurs on the phone and email dealing with insurance companies and referral coordinators and medical groups and on and on and on. It was more than a full time job but it was all worth it in the end. I learned how to play the game (it really seemed to be a game at times because there was absolutely no common sense involved) and I had to get nasty on more than one occassion but she always got what she needed and is doing just fine. Hang in there!

    Answer by FootballMom85 at 3:26 PM on Oct. 6, 2010

  • thanks. Why do they insist on the game? I swear some days i just want to send them a video of his eatting cereal (he maybe gets 10% actually into his mouth) and then put him on the phone to talk with them.... most people can only understand 1 or 2 words when he starts a conversation with them.

    Comment by nrfountain (original poster) at 3:53 PM on Oct. 6, 2010

  • I know how you feel. My sons insurance gives total hell over authorizing him getting tests. In his 2 short yrs of life he has been to 8 specialists and now has three therapists. And has several health issues along with delays. It's like it never ends. And I freaking hate insurance. A NURSE is sayiing what we can and can't get tested?????? WHAT!?

    Can you not get help from the state? My son qualified for the Division of Developmental disabilities here in AZ. Other states may have a similar program. Also, maybe look into getting state health care for your child too. Depending on how severe they are, they may qualify for the state to be secondary insurance, so they will pick up what your insurance doesn't pick up. We're going through this with our son currently.

    Answer by Mipsy at 10:37 AM on Oct. 7, 2010

  • its the state insurance thats giving me the run around right now. And yes i absolutely HATE being told what i can and cannot do with my son. I live with the kid and I know what his problems are. I can see what other kids his age are able to do and what he isn't doing..... What does the Division of Developmental disabilites do? Im in NM and I don't even know if we have something like that.

    Comment by nrfountain (original poster) at 5:58 PM on Oct. 7, 2010

  • Oh I completely know what you mean. I have state insurance for my DD and she is Autistic. One thing after another fighting to get what she needs, particularly with therapies. I wish you lots of luck.

    Answer by brknangel at 10:13 AM on Oct. 9, 2010

  • Look into what is called a Katie Beckett waiver, it helps parents of disabled children get help from their state reguardless of their income. we are fortunate right now, my DS is 2 and still gets early intervention services but that will end when he turns then we will find out if I am going to have to "Play the game" with our private insurance.

    Answer by heathers5500 at 5:39 PM on Oct. 9, 2010

  • lol here you go "heathers5500" you get the green piece.... I hope you never have to play the game but you probrably will. I really wish they would let you do what they know is necessary for your child and leave it at that. If its not necessary let the therapist and dr's let them know. And no offense but the thearapy through the schools is kinda a last ditch resort... 15 minutes once a week or every two weeks isn't gonna do much... better than nothing but not by much. Let the out of schools therapists with their whole hour get the real work done.

    Comment by nrfountain (original poster) at 8:59 PM on Oct. 10, 2010

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