Does Anyone Else Have a Child on the Spectrum and BCBS?

Are you working through your local Intermediate School District? Have you had regular contact with a social worker through the hospital/treatment center in your area?? Ask LOTS of questions and use the resources available to you. A social worker (either through the school district, community health care, or hospital) can help put you in touch with free or low-cost options or programs available to your family. Also, they may be able to help you negotitate your insurance options and better understand your coverages and find in-network providers if needed. Look at the back of your insurance card. Either call the 800 number or visit the website to find out more about all of the support and informational resources available through BCBS (there are many). Make sure you ask lots of questions and have them explain thoroughly any and all options that may be available. Good luck!!

there is a vote in michigan on tuesday to get this covered by insurance. write to your congressperson!!

Insurance struggles are a nightmare! I wish you luck in dealing with the whole issue.

If I may ask, do use dietary supplements with your child? I have been introduced to a series of dietary supplements designed for kids on the spectrum. I'd love your opinion on them...if you are willing! Thanks for listening.

Good luck!

S.
____@____.com

In Oakland County there are several support gorups through the Intermediatary school district that have lots of resosurces, I'm sure your county will have the same. Follow the suggestions of the others, as your child is young, you haven't gotten tt he school system yet, where many of these resources are offered. BC in Michigan doesn't pay for much, and their proposal will only pay for a small part of it, but it is a start. You might try one other resource, and that is a medical biller advocate, who might be able to give you some advice. You will have to pay for their time, but if you call and talk to one, let them know that you are looking for someone to help you get reimbursement from bcbs with the type of therapies you need and they might be able to tell you then if it is possible and worth pursuing or not. Get whatever therapies you can through the school district and county. Log onto www. wrightslaw.com, and click away to learn all that you can. Good luck.

I just read an article about BCBS starting to provide such coverage...it may be under mental health not physical health coverage. Call BCBS and call the HR person through which your insurance is provided.

Hi M.,

A lot of it depends on how your doctors office submits the claim. You might want to ask them. This also is a better question for the Autism Michigan Yahoo Group. The group is made up of professionals, parents, caregivers and individuals on the spectrum. They may be able to give you more specifics of whom to turn to, the right questions to ask or the right way to word your requests. This link should take you to the group. If not, email me back and I'll get the subscription link to you. (Copy and paste in your browser if it doesn't show as a link.) http://health.groups.yahoo.com/group/Autism-Michigan/

Another suggestion is maybe you could try twittering about it and see what comes up???

I hope this helps - S.

M.,
My own child isn't on the spectrum but my nephew is so I pay close attention to this issue (since it's been at least partially gentically linked). Right now, there are hearings happening in Lansing (the next one actually takes place on Tuesday!) to try to get legislation passed, requiring insurance companies to cover autism spectrum treatments. They're even asking for parents to testify how ABA has helped their kids (you can either testify in person or in writing). There are currently 14 states who have already passed this kind of legislation and if I remember correctly, Minnesota is one of them (which is likely why the family you know there has things covered). If you can find the time (I'm sure that your life already is insanely busy - but good for you for seeking the help for your daughter!) you may want to try to get involved in the group "AIM" - Autism Insurance in Michigan. They are fighting tirelessly to help get this legislation passed and they're currently making some huge strides. Even if you can't attend rallies or hearings (I can't), you can still write to your congressmen/women and state senators (which I've done). Their website is http://autisminsurancemi.blogspot.com.

Have you also considered coupling the ABA therapy with a nutritional approach? This has worked WONDERS for my nephew. He started with the ABA and made some progress but when his diet was adjusted (removing wheat and dairy and taking nutritional supplements), he turned into a totally different kid. His diagnosis actually improved from PDD-NOS to Aspergers just recently. The book "Healing the New Childhood Epidemic: AUtism, ADHD, Allergies, and Asthma" by Dr. Kenneth Bock outlines the program and offers many real-life cases of how the program helps along with therapies like ABA. My nephew's own DAN! doctor is one of the cases in the book (her daughter).

Best of luck to you - I can't even imagine having to make that decision to sell a house to cover therapies that SHOULD be covered! Hopefully the tide is shifting and you will see some positive change in insurance coverage in the near future!

I also would like to reccomend Jenny McCarthy's most recent book "Mother Warriors". It's truly inspiring to read about parents who are so dedicated to their kids' recovery!

Bless you!

Did you apply for Children's Special Healthcare? They might cover things your insurance does not.

You didn't say what area you are from or how old the child is. I have some of the same issues however my child has cp.
Like the others said, try your school district. I know northern oakland county school districs offer help.
My pediatrician gave me a list of local areas that will help with pt & ot. They are all free & are Federally funded. The workers are great.
Yes I also have bc&bs. My co-pays are 20 po & ot 3xs a week would mean $120 a week in just copays.
I am in the program early-on, through our school.
I would first talk to the childs Dr to get info on where you could get local help.
Good Luck