Friday, May 27, 2011

It just keeps gettin’ better and better!

**First, a disclaimer: What you are about to read is the whiny rant of a mom who is financially strapped, tired of fighting, stressed out, exhausted, and angry as hell. This post is not long, but it speaks to the struggle that thousands of families face both in my home state and across this nation. I know my situation is a walk in the park compared to others out there, but I just needed to vent. Thank you!**  
A couple of weeks ago I got a letter in the mail from our health insurance company in regard to an appeal for over 6 months of therapy charges that they denied. Their letter states:
“Based on a review of the submitted information in conjunction with the plan document language and healthcare policy, it has been determined that the charges…would not be medically eligible for benefits. Based on the documentation received, this child is autistic and there are no habilitative benefits under the medical plan.”
Welcome to insurance discrimination against autism, people. It runs rampant here in Washington.
As if it could not get any better, last night we got our new open enrollment packet for my husband’s work. The letter included stated:
“We must unfortunately raise the…plan rates this year…with an overall increase of 25%.”
We already pay close to $700 a month for medical and dental alone. With the new price increase, our cost is almost $800 a month, not including our other elections and deductions. I may have to sell a kidney here soon to pay for the benefits that my kids need (even though the dang insurance company refuses to pay on medically necessary claims).
So, instead of spinning my head around and spewing forth all of the venom I feel about our health insurance and financial situation, I thought it would be best if I just stopped writing now and simply posted a few more comics.

I removed a couple of letters on this pic. I think you get the idea! 


Becky@OrganizingMadeFun said...

I understand...we are getting vision therapy for our son. The insurance company won't pay for it. At $165 an hour {that's clinical hour}, it's VERY expensive but has so many benefits to our son. I was actually shocked to see that our PPO paid for 1/2 his speech therapy. You aren't alone, though! Do you have a flexible spending account? Are you able to deduct it on your taxes? We use our FSA every year - every single penny!

Becky B.
Organizing Made Fun

Cari said...

I can't even imagine hon. All I can say sucks!!!! It really just isn't fair, none of it and it is just a shame and a road block for what our children need to heal. Hang in there. I'm devising a plan to go undercover and work my way up in BlueCross Almighty and bring them down.

Caffeinated Autism Mom said...

Becky, I am so with you on the vision therapy! Our son needs it so much and we haven't been able to afford it for over a year now. And yes, we use flexible spending. It's an absolute must!

Cari, if you go undercover, I'll be the reporter that quotes an "anonymous source!" ;-)

Thanks to both of you fabulous gals for your comments.

Accidental Expert said...

Gotta love it. We're in debt up to our behinds to pay for our kids therapies. In our state, a law was passed mandating that autism therapies must be covered. Too bad it only applies to commercial plans -- this excludes personal insurance, self insured companies and medicaid. Whoopie!

Good luck.

Caffeinated Autism Mom said...

Accidental Expert, this is good info and thank you for sharing. I don't think it's commonly known that in the states where insurance reform for autism has already taken place, some folks are still left out - like you. I am sorry to hear this and I totally feel your pain. Cheers to being in medical debt! Best of luck to you as well.

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