Adrian

Adrian

Thursday, June 10, 2010

Autism is.... EXPENSIVE.

Our speech therapist has asked us to review our insurance claims to see why payment from them is slow. I haven't seen anything charged to our insurance for speech therapy services. She did receive a check for last year... I guess insurance is slow in paying. At the start of each year, we have a family health fund of $3,000. This 3k can be used for anything, in or out of network care. I have spent a little of this fund for this and that, Angela has spent some on her shots at her 6 month check up. Adrian is the big spender in this fund, he has since we got on this insurance. Four months into this year, and we spent 75% of this fund already. I start to look through the claims, to see where all this money went so fast. There were four specialists at the actual evaluation for autism... and each of them charged up to $800 for their own special "care" that day. There was also an overall charge for the day, of over $1,000. After our health fund runs dry, we have to pay for EVERYTHING out of our own pocket until we meet our deductible of $5,000... basically we would have to fork out $2,000 worth of medical treatment until the insurance would cover anything else under our plan. So, if I have to go to the ER for something crazy, we would have to pay the whole $2,000 and the insurance would pick up the rest, plus whatever 10 or 20% copay. So while I need to take care and not end up in the ER... same goes for my husband... the children are 100% covered, thanks to the state. I don't care what people think about it, but our children are covered under medicaid for whatever expenses our insurance company rejects. Basically, if it weren't for medicaid, we'd be buried up to our eyes in medical bills. There is also SSI, which sends a check to the family of a legally "disabled" child. This money goes toward medical and therapy expenses. We have to go through a very long and drawn out process for this... same goes for the DD Waiver. There was also the almost $1,000 in charges for when Adrian was horribly sick and required an IV for two days. Autism is expensive. Which is why I'm thankful for the secondary medicaid!

3 comments:

  1. Amen, sister! It's horrible. I'm actually going to be blogging about our health insurance situation tomorrow. It's abysmal, but it sounds like we're much better off than you! However, we have primo coverage, but it still sucks.

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  2. Yeah, our insurance plan isn't the best. Though my husband and I are pretty healthy and don't require lots of doctor visits, our children are another subject all together! I'm just glad we qualify for medicaid as a secondary insurance! My daughter may not need the extra coverage, but my son sure does!! Our program would be good for a young couple without children... not so good for a young couple with two children: one under a year old requiring all her shots and one with autism. I haven't even started on the food therapy yet... AHHH!!! So glad for medicaid!!!

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  3. Isn't it crazy! Our healthcare system needs to get some of their priorities straight!!!

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