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Insurance question??

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We have appealed 2x withour insurance company to get coverage for ST. We

finally won the appeal--they stated that for Apraxia, it was medically

neccessary. All was great. Then they came back and said they wouldn't pay

because our SLP is out of network. BUT when asked who was in the network, they

just said this Speech and HEaring Clinic in Indianapolis (I live in IN).

Indianapolis is 2.5 hours away! I know other states have a law about if the

provider is more than so many miles a way from you they have to allow you to see

another one that is closer. Our lawyer cannot find any law like this for IN. I

think this is ridiculous. They can't expect us to drive to Indy for ST and the

clinic they are talking about probably doesn't even offer ST!! My husband seems

to be wimping out on me doing exactly want the insurance company wants--giving

up. I wont do that. Right now I am working 2.5 days a week against my wishes

to pay for this therapy. We live in an area with a school system that is just

ridiculous and refuses to give more than 2 30 minute ST sessions a week. I am

also afraid my son is going to need more therapy because we seem to be going

towards an autism or PDD-NOS diagnosis. I have spent hours on the phone with

gov't agencies. No one can help. We make too much money for most funding but

yet we are so strapped! It makes no sense to me.

Can anyone help??

Zwick

bearcat@...

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