Re: Does KidCare cover speech and occupational therapy?

[Guest guest]

With medicaid you only get speech, OT and PT if medically necessary, not because you want it. On medicaid my son does not qualify for any of these services, that is why we had to wait 7+ years without ANY services from the age of 5-11 till we got the medicaid waiver. Even with the medicaid waiver services have a spending limit. Your child only gets 20 sessions a year, mine gets NONE.  I suggest applying for the uhccf grant which will cover therapies. Families on medicaid and kidcare do not qualify for this grant. Also if your child is diagnosed with autism, your son should qualify under the new autism insurance law to receive further assistance, and you may need to provide your insurance provider with the information on the law. The new law does not apply to those on medicaid on kidcare and services for families with autism are still not covered. Feel lucky that you have private insurance that covers autism, because many of us, do not.

 

My unitedhealthcare coverage stops at exactly 20 sessions.

I'm hoping that federal insurance for kids maybe covers more?

Wow, this is so unfair. I work like a dog to provide

for us, and because I have private insurance, my son can only get

20 sessions and that's it.

Someone who does not work at all will get more

therapies, just because they are low-income,

and therefore, qualify for Medicaid. Unbelievable.

I have to quit my job and live from the gov't

in order for my son to get the health coverage he needs ?!?

What about us folks who are in the middle.

Not poor, but definitely NOT RICH.

Would you have any idea, if KIDCARE insurace,

covers continuous therapies (speech and OT)?

thanks,

Ramona

>

> >

> >

> > Hello: I am sure that other parents out there have faced the dilemma,that

> > i'm currently in.

> > My son has maxed out nbr of therapies (20 sessions per year),

> > We are covered by my employer's insurance(UnitedHealthCare)

> > thru my fulltime job, (although that might change soon since

> > I need to scale back work and dedicate hours to taking my

> > son to much needed speech/occupation therapy).

> > Maybe my working less hours will help my son

> > to qualify for Medicaid/Medicare, etc.?

> >

> > Ive never even thought about applying for govertment insurance cause

> > I thought by me working fulltime, we would manage.

> >

> > Well, we all know

> > that therapy coverage is barely covered.

> >

> > Is there anyway, if I apply for Medicaid that he would have

> > more coverage for more therapy this way? And then I would

> > just drop him from my private insurance. Would he even

> > qualify?

> >

> > Which diagnosis gets more coverage for services?

> >

> > His neurologist wrote Asperger's diagnosis,

> > although my son barely speaks. Has heavy echolalia

> > and spaces out. Cannot converse.

> >

> > The pediatrician, on the other hand,

> > disagrees with the neurologist and told me

> > that he is definitely PDD (and not Asperger's).

> >

> > I don't know if I should just call the neurologist and ask him for for a

> > script that says " PDD " ?

> >

> > Or if I can apply for Medicaid or something, with the

> > current diagnosis paper that says ASPERGER.

> >

> > Is Aspergers considered eligible for Medicaid or Medwaiver?

> >

> > I just want help with getting his therapy covered.

> > I see mom's sitting next to me at his last therapy

> > center and they didn't even work. How could they

> > afford therapy for their child?

> >

> > I'm so confused. I just want to get

> > more coverage for therapy he desperately needs. He started

> > in an Autism Kindergartten and does not understand when

> > spoken to, and can't even hold a crayon?? His IEP

> > offers school-based speech every day for 30 minutes

> > and OT only once a week. His doctor assures me that

> > this therapy is not enough. I must supplement both

> > speech/occupation therapy, outside of school.

> >

> > Can I apply for public assistance/services for my son who is on the

> > spectrum,

> > regardless if he's asperger's or PDD or whatever?

> > Please help? Your advice is appreciated...

> > thanks,

> > Ramona

> >

> >

> >

>

>

>

> --

>

> AutismOnTheGo.com

>

-- AutismOnTheGo.com

[Guest guest]

If you live in broward you must select CMS as your plan and you get unlimited ot and speech as needed for your child.Gaby

My unitedhealthcare coverage stops at exactly 20 sessions.

I'm hoping that federal insurance for kids maybe covers more?

Wow, this is so unfair. I work like a dog to provide

for us, and because I have private insurance, my son can only get

20 sessions and that's it.

Someone who does not work at all will get more

therapies, just because they are low-income,

and therefore, qualify for Medicaid. Unbelievable.

I have to quit my job and live from the gov't

in order for my son to get the health coverage he needs ?!?

What about us folks who are in the middle.

Not poor, but definitely NOT RICH.

Would you have any idea, if KIDCARE insurace,

covers continuous therapies (speech and OT)?

thanks,

Ramona

>

> >

> >

> > Hello: I am sure that other parents out there have faced the dilemma,that

> > i'm currently in.

> > My son has maxed out nbr of therapies (20 sessions per year),

> > We are covered by my employer's insurance(UnitedHealthCare)

> > thru my fulltime job, (although that might change soon since

> > I need to scale back work and dedicate hours to taking my

> > son to much needed speech/occupation therapy).

> > Maybe my working less hours will help my son

> > to qualify for Medicaid/Medicare, etc.?

> >

> > Ive never even thought about applying for govertment insurance cause

> > I thought by me working fulltime, we would manage.

> >

> > Well, we all know

> > that therapy coverage is barely covered.

> >

> > Is there anyway, if I apply for Medicaid that he would have

> > more coverage for more therapy this way? And then I would

> > just drop him from my private insurance. Would he even

> > qualify?

> >

> > Which diagnosis gets more coverage for services?

> >

> > His neurologist wrote Asperger's diagnosis,

> > although my son barely speaks. Has heavy echolalia

> > and spaces out. Cannot converse.

> >

> > The pediatrician, on the other hand,

> > disagrees with the neurologist and told me

> > that he is definitely PDD (and not Asperger's).

> >

> > I don't know if I should just call the neurologist and ask him for for a

> > script that says "PDD"?

> >

> > Or if I can apply for Medicaid or something, with the

> > current diagnosis paper that says ASPERGER.

> >

> > Is Aspergers considered eligible for Medicaid or Medwaiver?

> >

> > I just want help with getting his therapy covered.

> > I see mom's sitting next to me at his last therapy

> > center and they didn't even work. How could they

> > afford therapy for their child?

> >

> > I'm so confused. I just want to get

> > more coverage for therapy he desperately needs. He started

> > in an Autism Kindergartten and does not understand when

> > spoken to, and can't even hold a crayon?? His IEP

> > offers school-based speech every day for 30 minutes

> > and OT only once a week. His doctor assures me that

> > this therapy is not enough. I must supplement both

> > speech/occupation therapy, outside of school.

> >

> > Can I apply for public assistance/services for my son who is on the

> > spectrum,

> > regardless if he's asperger's or PDD or whatever?

> > Please help? Your advice is appreciated...

> > thanks,

> > Ramona

> >

> >

> >

>

>

>

> --

>

> AutismOnTheGo.com

>

[Guest guest]

I mean no disrespect but, "Welcome to the group". I don't know of any autism group that isn't fighting for what you might call Universal Health Care for Autism. Unfair? I really can't think of anything more unfair. We can spend millions for research which does nothing for present situations. You are perhaps one more vote for dong the right thing for our children. Eventually these votes are going to add up action by the proper authorities. It's a shame that we have to wait for an epidenic before the government takes the proper action.

Although most insurance companies don't cover autism something tells me 20 sessions per year isn't really "coverage" for anything. These sessions are an average of less than 1 session per two weeks.

The state mandate may help if your employer is not self-insured and there are more than 50 employees on the policy. The self-insured disqualification affects a lot of policy holders. Heifferon

To: sList From: mamabear_sunrise@...Date: Tue, 6 Oct 2009 20:50:20 +0000Subject: Does KidCare cover speech and occupational therapy?

My unitedhealthcare coverage stops at exactly 20 sessions.I'm hoping that federal insurance for kids maybe covers more?Wow, this is so unfair. I work like a dog to providefor us, and because I have private insurance, my son can only get20 sessions and that's it.Someone who does not work at all will get more therapies, just because they are low-income,and therefore, qualify for Medicaid. Unbelievable.I have to quit my job and live from the gov'tin order for my son to get the health coverage he needs ?!?What about us folks who are in the middle.Not poor, but definitely NOT RICH.Would you have any idea, if KIDCARE insurace,covers continuous therapies (speech and OT)?thanks,Ramona> > >> >> > Hello: I am sure that other parents out there have faced the dilemma,that> > i'm currently in.> > My son has maxed out nbr of therapies (20 sessions per year),> > We are covered by my employer's insurance(UnitedHealthCare)> > thru my fulltime job, (although that might change soon since> > I need to scale back work and dedicate hours to taking my> > son to much needed speech/occupation therapy).> > Maybe my working less hours will help my son> > to qualify for Medicaid/Medicare, etc.?> >> > Ive never even thought about applying for govertment insurance cause> > I thought by me working fulltime, we would manage.> >> > Well, we all know> > that therapy coverage is barely covered.> >> > Is there anyway, if I apply for Medicaid that he would have> > more coverage for more therapy this way? And then I would> > just drop him from my private insurance. Would he even> > qualify?> >> > Which diagnosis gets more coverage for services?> >> > His neurologist wrote Asperger's diagnosis,> > although my son barely speaks. Has heavy echolalia> > and spaces out. Cannot converse.> >> > The pediatrician, on the other hand,> > disagrees with the neurologist and told me> > that he is definitely PDD (and not Asperger's).> >> > I don't know if I should just call the neurologist and ask him for for a> > script that says "PDD"?> >> > Or if I can apply for Medicaid or something, with the> > current diagnosis paper that says ASPERGER.> >> > Is Aspergers considered eligible for Medicaid or Medwaiver?> >> > I just want help with getting his therapy covered.> > I see mom's sitting next to me at his last therapy> > center and they didn't even work. How could they> > afford therapy for their child?> >> > I'm so confused. I just want to get> > more coverage for therapy he desperately needs. He started> > in an Autism Kindergartten and does not understand when> > spoken to, and can't even hold a crayon?? His IEP> > offers school-based speech every day for 30 minutes> > and OT only once a week. His doctor assures me that> > this therapy is not enough. I must supplement both> > speech/occupation therapy, outside of school.> >> > Can I apply for public assistance/services for my son who is on the> > spectrum,> > regardless if he's asperger's or PDD or whatever?> > Please help? Your advice is appreciated...> > thanks,> > Ramona> >> > > >> > > > -- > > AutismOnTheGo.com>

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[Guest guest]

What's sad is we're paying 256 a month for both my kids for Kidcare! Apparently we make too much money also. If we made too much then I wouldn't have to go to kidcare. Individual insurance has the same monthly rate. I stick with it because there are no deductables and surprise fees but it's annoying when I see people in the doctors office and I know they are only paying like 10 bucs a month for the same coverage.

Does KidCare cover speech and occupational therapy?

My unitedhealthcare coverage stops at exactly 20 sessions.

I'm hoping that federal insurance for kids maybe covers more?

Wow, this is so unfair. I work like a dog to provide

for us, and because I have private insurance, my son can only get

20 sessions and that's it.

Someone who does not work at all will get more

therapies, just because they are low-income,

and therefore, qualify for Medicaid. Unbelievable.

I have to quit my job and live from the gov't

in order for my son to get the health coverage he needs ?!?

What about us folks who are in the middle.

Not poor, but definitely NOT RICH.

Would you have any i

dea, if KIDCARE insurace,

covers continuous therapies (speech and OT)?

thanks,

Ramona

>

> >

> >

> > Hello: I am sure that other parents out there have faced the dilemma,that

> > i'm currently in.

> > My son has maxed out nbr of therapies (20 sessions per year),

> > We are covered by my employer's insurance(UnitedHealthCare)

> > thru my fulltime job, (although that might change soon since

> > I need to scale back work and dedicate hours to taking my

> > son to=2

0much needed speech/occupation therapy).

> > Maybe my working less hours will help my son

> > to qualify for Medicaid/Medicare, etc.?

> >

> > Ive never even thought about applying for govertment insurance cause

> > I thought by me working fulltime, we would manage.

> >

> > Well, we all know

> > that therapy coverage is barely covered.

> >

> > Is there anyway, if I apply for Medicaid that he would have

> > more coverage for more therapy this way? And then I would

> > just drop him from my private insurance. Would he even

> > qualify?

> >

> > Which diagnosis gets more coverage for services?

> >

> > His neurologist wrote Asperger's diagnosis,

> > although my son barely speaks. Has heavy echolalia

> > and spaces out. Cannot converse.

> >

> > The pediatrician, on the other hand,

> > disagrees with the neurologist and told me

> > that he is definitely PDD (and not Asperger's).

> >

> > I don't know if I should just call the neurologist and ask him for for a

> > script that says "PDD"?

> >

> > Or if I can apply for Medicaid or something, with the

> > current diagnosis paper that says ASPERGER.

> >

> > Is Aspergers considered eligible for Medicaid or Medwaiver?

> >

> > I just want help with getting his therapy cove

red.

> > I see mom's sitting next to me at his last therapy

> > center and they didn't even work. How could they

> > afford therapy for their child?

> >

> > I'm so confused. I just want to get

> > more coverage for therapy he desperately needs. He started

> > in an Autism Kindergartten and does not understand when

> > spoken to, and can't even hold a crayon?? His IEP

> > offers school-based speech every day for 30 minutes

> > and OT only once a week. His doctor assures me that

> > this therapy is not enough. I must supplement both

> > speech/occupation therapy, outside of school.

> >

> > Can I apply for public assistance/services for my son who is on the

> > spectrum,

> > regardless if he's asperger's or PDD or whatever?

> > Please help? Your advice is appreciated...

> > thanks,

> > Ramona

> >

> >

> >

>

>

>

> --

>

> AutismOnTheGo.com

>

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