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Autism - Support Across the Spectrum Autism - Support Across the Spectrum
Is anyone familiat witj the coverage here in Michigan
Posted on the NEW CafeMom Mobile
by on Feb. 14, 2013 at 9:27 PM
Replies (11-12):
mrsedawn
by on Feb. 18, 2013 at 9:23 PM
Huh im lost sry
Posted on the NEW CafeMom Mobile
Hottubgodess
by Jackie on Feb. 20, 2013 at 3:54 PM
1 mom liked this

You can also call the states attorney general office.  I know several families having trouble with BCBS with the same problem.  They are refusing to pay for ABA.  

Quoting AMom29:

 

Quoting mrsedawn:

What r theycoverin cuz i cannot get any help.speech aba therapy etc.ty

 OK, what you actually have to do is find out one thing from your employer, is your plan "self-funded"?  This is a huge determining factor that will decide where you go from here.

If it's NOT a "self-funded" plan, then Michigan law now requires that those items are covered.  However, you have to jump through a few hoops to make this happen.  There are four sites across the state that are approved to diagnose your child for eligibility for coverage -- DeVos Children's Hospital in Grand Rapids, U of M Children's Hospital in Ann Arbor, Henry Ford Hospital, and one location in the U.P.  Be prepared to be put on a waiting list IF you have not done this step already.

Then you need to call your insurance directly to see what they cover and what they require.  You can call them BEFORE the assessment is done, but you might want to try to get on that waiting list, first.

If you plan IS "self-funded" (and this is where I'm at), you are in for a world of hurt.  Self-funded insurance plans (meaning the employer funds the insurance and uses the insurance company as administrators for the claims) are excluded from the new legislation.  There was a $15M budget set aside for employers to use to pay for services (using the insurer as an administrator of funds), but you, the employee, have to convince them to do this.  In my case, we've been unsuccessful at getting them to get on the ball and approve using these funds.  I'm not alone, as many companies in my area are "self-funded" and aren't keen about going down some complicated road. 

You can find more information at this web site: http://autismallianceofmichigan.org/

Are you on the Family Subsidy for ASD?  If not, contact your local Community Mental Health office to apply.  It's a small stipend that the state will pay based on your child's ASD diagnosis.  I emphasize small in comparison to the cost of therapy, but it's better than nothing.

Hope this helps, let me know if I can help more.  Thanks.


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