Let the Insurance Fun Begin

Next week will be BUSY!! 
The 28th we have Rory's Speech Therapy (a real speech therapist) assessment.
The 29th we have Early Intervention 
The 30th we have his first ABA appointment-Maybe

I need a real life besides appointments and errands. Any suggestions? Anyone? Sigh.  

With all these up coming appointments I thought it best to call our insurance provider on Monday to find out what limits and costs we're looking at. For speech therapy he's only allowed 20 sessions per YEAR. It doesn't matter if the session is 30 minutes or an hour, he's only allowed 20. That's roughly 1 session every 2.5 weeks. 

I verified that he's allowed 600 hours of ABA therapy a year. That's only 11.5 hours per week, way below the recommended 15-20 hours per week. I'm hoping they can teach me some skills so I can make up for the lack of actual 1-on-1 session time. 

Want to know the fun part? Our plan only allows for individual deductibles and individual out of pocket max, not a family one. So each person has to hit their own deductible and out of pocket max, which is more costly than the family deductible version. Yeah. 

On Friday his Speech Therapist's office called back with bad news. Speech therapy wasn't covered under our insurance plan unless the need for therapy was due to an injury or illness. That led to me spending over 45 minutes, 1 customer service rep and 2 supervisors researching if autism is considered an "illness" with the insurance provider. According to their findings, as long as the therapist code it under Autism, it should be covered. Should is the key word. I called back his speech therapist and gave them the new information. 

The insurance rep uncovered additional bad news (because they're an insurance company after all). The place where we are planning on getting Rowan's ABA therapy is out of network. Yeah, we're still working on that one. The question now is do we go with our original therapist or do we try to find 1 of the 6 in-network providers? 

Update: I did find the 1 provider with a location around our preferred area. They have a wait list of 6-8 weeks. I went ahead and placed Rowan on it, just to be on the safe side. I'm betting we'll have to go with this new provider, like it or not.

For Early Intervention this week we mostly reviewed Anastasia's new goals for the next 6 months. She meet or surpassed all of her goals but 1 - the tongue thrust issue she has when she eats. Anastasia's new goals are: 

• Cruising (Walking along furniture for support)
• Walk at least 5 feet unassisted 
• Sitting up with no hands to balance herself
• Eat table food
• Drink from a real cup -- They brought a special cup to help aid her and Rowan to drink from.

On Friday Heidi Anne had parent teacher conference. She's doing okay in school. She either gets A's or C's, there is no in between with her. I'm trying to get her on a 504 Plan since a recent re-evaluation on her ADHD revealed that she's gotten worse and she now has anxiety issues as well. The hope is; to help alleviate some of the stress of testing, doing verbal tests versus written ones, gentle reminders to turn in her homework. Once we move she'll start therapy to aid Heidi Anne to control her anxiety and rein in her ADHD. 

We had plans to go to Bear River Parkway Trail and park, but then it snowed and rained. Every time we make plans as a family to go to the park, it rains or snows. So the next time there's bad weather, just know, we more then likely had made outdoor plans for that exact moment.  

This weekend I took Heidi Anne to go see my first movie in the theater in nearly 6 years! It was Beauty and the Beast. Yes, I am one of those people who've been anxiously awaiting the arrival of this life action version of a Disney classic. The cartoon version was my first movie theater experience. Needless to say, I love this movie. 

I did learn something, I haven't passed the love of this movie onto Heidi Anne. How do I know? Because just before a musical number started I would accidentally start humming the tune. Towards the middle of the movie Heidi Anne looked at me and asked in awe "Mom, how do you know all these songs?!?" I told her "Ssshhhh, because I'm psychic." To which she gave me a smile and a well deserved eye roll.