Insurance--its just not right

[admin]

I called to inquire about a new PT facility. They are a "preferred provider" but I still have to pay a $25 copay at each visit. Assuming we keep weekly visists as we have through CCS this is $100 per month on top of the premiums we pay for medical coverage.

It just doesnt seem right to me that all PT is covered the same way. I asked and they told me that it doesnt matter what caused the injury it is all paid out the same way. So frustrating to me that some schmuck who needs knee PT after playing too many games of football is treated the same way as our children. It just makes me so upset.

[admin]

Does your state give your child Medicaid? Check with www.nichcy.org - there may be additional insurance that your state can give you that will pay the copays. Some states do this, some states don't. Dig deep to find out. Our state does this and it covers deductibles and copays.

[brandonsmom]

In our state we have a program called KID CARE-I live in Illinois. It is run by the Welfare department but is not welfare. We get reimbursed some of the money we pay for premiums. I did not think we would be eligible but we were. The rebate program as they call it is for people with private insurance who just want some of their money back.
There are other programs one of which you can get a medical card. It is for kids, the application is very easy to fill out and they approve you pretty fast. We pay $190.00 a month for insurance and they send us a check once a month for $105.00. They reimburse all the kids portion that we have to pay out of pocket. Check with your state, most states should have a program like this. We make pretty good money and still qualified. You only have to submit documentation once a year.....I know it is not alot, but every little bit helps.

[Tanya in NY]

We live in NY State and our daughter, Amber, got qualified for a program called Medicaid Waiver. It is Medicaid with all the same benefits, but she was qualified based on her "disability" and not on our income. We would never have qualified based on income! We were at first told by my daughter's caseworker through Early Intervention that there were no programs available to help with paying for therapy, but once I dug deeper and my friend gave me contact names (she has an autistic son), the ball started rolling. Now Amber receives aquatic therapy because our private insurance and Early Intervention would NOT pay for aquatics, but the Medicaid Waiver program does. And they pick up any co-pays once our private insurance pays for our therapy sessions, doctors visits, etc. It is a wonderful program. Check into it in the state you live in. There are many different names it may go by depending on the state you live in.

Good luck.

Tanya in NY

[admin]

I don't know where you live (but available in every state) you can contact an organization called ECI early childhood international, they offer the services of PT and OT for children under 3 of age with BPI injury. It is free of charge.
Good luck.
Vancemom

[Monika]

I count myself lucky that we have an insurance that will pay anything for PT/OT, with only a $25 co-pay.

- When my daughter was born we had an HMO, & after the first 90 days after the injury, they refused to pay for anything at all & we had to pay 100% out of pocket. At the time that was $60 a week for 5 months(on top of paying our regular premiums) - until we changed insurance companies.

So I think it is all at how you look at it...

[admin]

At least you don't have a cap on how many visits you are allowed each year. We pay $55.00 a visit and we have good insurance. Aetna was really good in regards to therapy. We do not have Aetna anymore though.

Lisa