When you have a child with a medical condition or a disability you aren't prepared for a lot of things on your road ahead. One thing I never thought I would have to worry about is waiting for insurance to approve medical care that is clearly covered under our plan. After all, you go to the doctor to get a diagnosis and get recommendations. If the doctor prescribes a medication or service it should be common sense that it is in the best interest of the child or patient right?
Our private insurance came with a book that goes over things they cover and things they don't. Right there in the book it clearly states that they will cover $42,000 a year of ABA therapy services from a licensed agency/therapist. Sounds simple enough right? Well imagine my surprise when I go out to my mailbox and pull out a letter from our insurance company denying ABA services. Their reasoning was that they didn't get a comprehensive background check from the lead therapists that would be working with my son that the center sent FIVE times! This is private insurance we are talking about why exactly does their background check matter seeing that this is a licensed center? Why can't I get anyone to give me answers or return a call? You take our $400 a month without batting an eye shouldn't that entitle me to a phone call.
To top it off the letter says at the end you can appeal this decision or send in the requested information upon receiving it we can then determine if these services are medically necessary. WHAT? First, our doctor prescribed these services -- they are proven to work and are recommend for children who have our diagnosis. Second, couldn't you find out if it would be qualified as a medically necessary service before you go as far to deny him for something as simple as a background check? Third, its written in black and white that it IS covered so obviously your company is aware that its a medically necessary service! Gah!
Don't even get me started on trying to get him disability insurance through the state! I applied in May its nearly November and we're still waiting. Maybe by the time he starts kindergarten he'll be approved for ABA therapy services. Sheesh!
Friday, October 26, 2012
Sunday, October 21, 2012
Vacations!
The word vacation can make any parent tremble. Most anyone who you ask (that will speak the truth or didn't have an amazing babysitter with them) will tell you that when they got back from their vacation they needed a vacation to recover from their vacation! When you add an Autistic child into the equation it can become even more of a stressful thing. This past weekend we stayed at a hotel a couple hours away with family which was hardly a vacation, but it was a trip away and hey who would say no to that!
Many if not most days, I completely forget that Cade has Autism. My daughter had no problem running into the hotel room and greeting her grandpa that she hadn't seen in months. My son on the other hand clung with a death grip to my husband until he felt comfortable that we weren't going anywhere. Any trip to the bathroom would make him burst into tears. Eventually he became comfortable enough to relax and have fun!
The pool was a whole other experience. I should say that my son loves water. If you say the word bath he will RUN to the bathtub before you can turn the water on. The pool through his eyes must have looked like a huge ocean with sharks swimming in circles around you. He looked at us like we were nuts for being in the water and he was not coming in under any circumstances. Being the mean mommy that I am I grabbed him and held tightly and started swinging him through the water trying to get him to see that it was okay and that the sharks wouldn't bite! (Yes he actually likes being swung around.) He was fine being in my arms but the look on his face when I tried to pass him off to my husband you would have thought I was feeding him to a shark. Eventually he realized that both mommy and daddy weren't going to let anything happen to him. For a little boy who was SO scared of the water he sure did have a great time -- even jumping off of the edge of the pool 10 million times! As much as he ended up liking the pool he loved the hot tub even more. He said bubble a few weeks ago and I completely forgot about it until the jets turned on and he started squealing bubble bubble!
We could only be in the pool and hot tub for so many hours before we would have shriveled up completely and we wanted to pack in as much fun as possible so we took the kids to this huge indoor bowling center/arcade place. We take Cade out all the time and he usually is an awesome little boy but in retrospect I think he probably could have used a nap before we went anywhere else! (Heck we could have all used a nap!) He crawled up the ski-ball machine, clung onto another parents leg (not every man with a beard is daddy LOL), tried to "help" the other kids who were playing their games, and then ran half way down the bowling lane as my husband rushed after him and mean mom made him go in time out. It was about this point that I was reminded that my son has Autism. The lady behind the counter where you get your shoes looked horrified. I'm not sure if she was horrified that I let him run around when he was so naughty, was mean to him and instead of immediately leaving made him sit in time out so his sister could finish, or what exactly her thoughts were but if looks could talk YIKES! As soon as my daughter finished her turns we did leave but unless if he was uncontrollable or didn't calm down I am not going to make her miss out completely on his behavior, and Autism or not he needs a consequence for his decisions because he does understand the word NO, and if we had waited until we got to the car or back "home" he would have no idea what we were scolding him about. It was about this point that I started thinking about the kids who throw tantrums while their parents are trying to shop and you know we've all thought it in our heads. Oh give the kid that candy bar, or let them ride that ride, gosh those parents should control their kid -- if that was my kid they wouldn't be acting like that. You know what sometimes its not that easy and unless you've walked a mile in that persons shoes you have no idea. Plus if everyone who had a child that has ever acted up in public stayed home out of fear their child would misbehave, I can guarantee not too many people would be outside of their house!
After a much needed nap (for all of us) we had a great dinner in public tantrum free, a great mini vacation, and while I'm not booking tickets to Disney World quite yet, we're not taking it off the bucket list either!
Many if not most days, I completely forget that Cade has Autism. My daughter had no problem running into the hotel room and greeting her grandpa that she hadn't seen in months. My son on the other hand clung with a death grip to my husband until he felt comfortable that we weren't going anywhere. Any trip to the bathroom would make him burst into tears. Eventually he became comfortable enough to relax and have fun!
The pool was a whole other experience. I should say that my son loves water. If you say the word bath he will RUN to the bathtub before you can turn the water on. The pool through his eyes must have looked like a huge ocean with sharks swimming in circles around you. He looked at us like we were nuts for being in the water and he was not coming in under any circumstances. Being the mean mommy that I am I grabbed him and held tightly and started swinging him through the water trying to get him to see that it was okay and that the sharks wouldn't bite! (Yes he actually likes being swung around.) He was fine being in my arms but the look on his face when I tried to pass him off to my husband you would have thought I was feeding him to a shark. Eventually he realized that both mommy and daddy weren't going to let anything happen to him. For a little boy who was SO scared of the water he sure did have a great time -- even jumping off of the edge of the pool 10 million times! As much as he ended up liking the pool he loved the hot tub even more. He said bubble a few weeks ago and I completely forgot about it until the jets turned on and he started squealing bubble bubble!
We could only be in the pool and hot tub for so many hours before we would have shriveled up completely and we wanted to pack in as much fun as possible so we took the kids to this huge indoor bowling center/arcade place. We take Cade out all the time and he usually is an awesome little boy but in retrospect I think he probably could have used a nap before we went anywhere else! (Heck we could have all used a nap!) He crawled up the ski-ball machine, clung onto another parents leg (not every man with a beard is daddy LOL), tried to "help" the other kids who were playing their games, and then ran half way down the bowling lane as my husband rushed after him and mean mom made him go in time out. It was about this point that I was reminded that my son has Autism. The lady behind the counter where you get your shoes looked horrified. I'm not sure if she was horrified that I let him run around when he was so naughty, was mean to him and instead of immediately leaving made him sit in time out so his sister could finish, or what exactly her thoughts were but if looks could talk YIKES! As soon as my daughter finished her turns we did leave but unless if he was uncontrollable or didn't calm down I am not going to make her miss out completely on his behavior, and Autism or not he needs a consequence for his decisions because he does understand the word NO, and if we had waited until we got to the car or back "home" he would have no idea what we were scolding him about. It was about this point that I started thinking about the kids who throw tantrums while their parents are trying to shop and you know we've all thought it in our heads. Oh give the kid that candy bar, or let them ride that ride, gosh those parents should control their kid -- if that was my kid they wouldn't be acting like that. You know what sometimes its not that easy and unless you've walked a mile in that persons shoes you have no idea. Plus if everyone who had a child that has ever acted up in public stayed home out of fear their child would misbehave, I can guarantee not too many people would be outside of their house!
After a much needed nap (for all of us) we had a great dinner in public tantrum free, a great mini vacation, and while I'm not booking tickets to Disney World quite yet, we're not taking it off the bucket list either!
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