Thursday, October 12, 2006

Just When I'm Starting to Feel Good...

...Riding on an Elmo porn high, well-caffeinated, etc., I get knocked back down by the everyday crap.

Yesterday, we received a letter from the University of Washington, where Hutton goes for his ABA therapy. (The link includes a good overview of what ABA is. It's basically the treatment most widely accepted as being helpful for Autism. The fact that it is expensive and not covered by most insurance plans is just an added challenge for parents of kids with Autism.) However, our insurance plan does cover ABA therapy. Or 80% of it. Still, a lot better than paying everything out of pocket. That is, our insurance is supposed to cover it, but I keep having issues with our provider. The woman in charge of getting our ABA covered keeps finding problems. The letter we received from the UW told us that we'd be "private pay" for the rest of the year because we are over our allotment. Our allotment of 60 case management visits. That would be at least one visit a week for an entire year. We've averaged about 1 visit A MONTH with our old case manager, which is one of the reasons we switched to the UW. So, 1 visit a month from January to July, followed by weekly visits from mid-August till today, equals less than 60, when I add them. Of course, as you know math isn't my strong suit. But still. Even if I fudge the math a bit, it's still nowhere near 60. There's NO WAY IN HELL we've used 60 case manager visits for 2006. So, I've been trying to get in touch with someone at our insurance company for the past day, and have gotten nowhere. The main woman, who alerted the UW to our "red flag" status, is on vacation this week. Her assistant doesn't appear to be in her office in the afternoons. Oh, and did I mention we had the same exact thing happen in June, and they realized there was a mistake, and we all went on our merry way? Well, I guess they just lost the file, and rediscovered it, and forgot about the whole, "Oh, wait, that's wrong, you still have lots of case manager visits left for the year" discussion we had a few months ago.

OK, still, not that big of a problem. It will be resolved. I was fine with having that to tackle today. Until I got an email from Hutton's teacher. Hutton's behavior has become "increasingly inappropriate" for kindergarten and "he does not seem ready for the demands of kindergarten." Great. I cried. I stopped crying for a few minutes as I tried to contact the parent liason from Hutton's preschool to talk me down. She wasn't there, and the woman I spoke with at the local school with a contained learning program told me she'd try to find someone who knew something to call me back. I'm still crying. My child is being kicked out of Kindergarten. My life is not going so well today.

6 comments:

Schmoop said...

Call Rep. Joe Barton, he'll try to help...Not...Lousy bastard...These payments and limits are things that parents and their kids in this freakin country shouldnt have to worry about.

Laura said...

Well, it's going to be even better when these kids are all draining social security. The current rate of Autism is 1 in 166. It would seem like a better idea to treat them now, so they can stand a chance of contributing to society. But, hey, Joe has our best interests at heart, right? He doesn't want his fabulous NIH reform bill getting sidelined by this Autism stuff. I'm sure his NIH bill will more than cover the Autism figures. Sure, Joe.

Schmoop said...

I believe his NIH bill contains only 15 mil for autism use...Pediatric Aids, Jv Diabetes, and other diseases would receive far more dollars and yet the rates of those diseases are far less than Autism.

Laura said...

Yeah, that's the problem. The Combating Autism focuses on Autism only,and doesn't have to split the money with bunches of other diseases whose treatments are probably covered by insurance. And you're right about those diseases being far less common. The best treatment for Autism isn't covered by insurance, so a bunch of people get together to create a bill to help with that, it easily passes in the Senate, and then this dickhead steps in the way. He just wants HIS bill passed, and doesn't give a shit about Autism. Well, hopefully the parents in TX will be sure to keep that in mind when he is up for re-election. Very frustrating!

Kristen said...

Oh, Laura, I'm so sorry. I can't believe Hutton's teacher sent you a letter and didn't call you directly to talk to you about possible solutions. I am so, so sorry about this. As if the insurance crap wasn't enough. ((hugs))

Kim Rossi Stagliano said...

Law-rer, we're in the U Wash genetics study. Our Hat Trick of autism is most appealing to geneticists. Girls at that!

People have no idea how utterly consuming having a child with autism is -- with none of the support of say, cancer or leukemia. We're just out here trying to recover our kids completley on our own.

There ain't no such thing as a genetic epidemic. SOMETHING triggered autism in my girls. And no one has the balls to really investigate -- even post Evidence of Harm (DK is a friend and hero to me.)

Kimbally.

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