Autism Insurance Reform: Special Needs Living

Sheri Reed

mother son sunsetDid you know many autism-related therapies and treatments are not covered by health insurance carriers? Or that some insurers consider autism to be a "pre-existing condition"?

Yep, that's right. Much like the rest of our healthcare system, autism insurance is in great need of reform!

This week in Special Needs Living, CafeMom aurorabunny, mom to 3-year old Brody, who has autism, discusses her hopes for Autism Insurance Reform in 2010.

A new year and a new hope for Autism Insurance Reform

by aurorabunny

I can remember that at exactly this time last year, my husband and I were both very excited and nervous to hear that a bill suggesting autism insurance reform was to be introduced in our state. The aforementioned bill would have made it mandatory for insurance companies to provide coverage for autism diagnosis and treatment. Much to our sadness, this bill was sent back before it was able to hit the House floor for debate, and we had to console ourselves with yet another, "Maybe next year..."

"Next year" came around quickly and here we are again, wondering if another bill will be introduced here in Missouri and hoping that the next one might make it into law. In the past two years, six states — Texas, Pennsylvania, Arizona, Florida, South Carolina, Louisiana — passed laws requiring coverage of therapies for children with autism, and several other states passed such laws much earlier on. 

We personally pay quite a bit to a private insurance company for our coverage and when Brody was first diagnosed with autism, I had to fight them tooth and nail over EVERYTHING. Since he has started school, they have started approving more and more claims for his therapies and have become much more accommodating. I'm very thankful for this even if I don't have any reason as to why the change occurred.

However, I see the flip side of the situation almost every day, especially with other families at Brody's school. The majority have told me that their insurance covers nothing autism related, and one mother has even told me that her husband's insurance (which is through his job and would normally cover the entire family) will not even extend health coverage to her son because of his autism being a "pre-existing condition." When she asked them what exactly she was supposed to do if her son became ill or needed to see a doctor, the insurance representative on the other end of the phone suggested that she ask her husband's employer (a very large company) to change insurance providers. How helpful.

I'll admit that it's very hard not to become bitter once you see your claims for important therapies or tests just being refuted by your insurance company over and over again. This becomes even harder while watching friends and family members get insurance assistance for smoking cessation aids, diet pills, and things of that nature. I've sat and wondered many times what entitles someone to insurance assistance to quit smoking, stop doing drugs, or lose weight while my child (and millions of others) apparently does not deserve to learn how to walk or speak. While it's human nature to feel that way, I've finally come to the conclusion that the best thing I and others can do is to keep fighting.

Write letters, get in contact with your local officials, and let your insurance company know how you feel. That's what I'm in the process of doing right now, and I have my fingers crossed that maybe this year will be the year.

Does your state offer insurance coverage for children with autism? 


Previous Special Needs Living posts from aurorabunny:

5 Tips for Special Needs Gift-Buying: Special Needs Living

Balancing Playtime & Therapy Time: Special Needs Living

The Holidays & Autism: Special Needs Living

The Autism-Vaccine Controversy: Special Needs Living

Sick Special Needs Kid Woe

Announcing Autism

What NOT to Say About Autism

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