Some children are quickly diagnosed after birth with a special need, whether that be a cleft palate or a more severe genetic condition. Other children grow up seemingly typical, but then are diagnosed at a later date with a special need. For instance, my brother had cerebral palsy, but he wasn’t diagnosed until after a year old. Much of his development until that point had been normal. Some children are diagnosed with issues even later. A family friend’s son was not diagnosed with high functioning autism until he was 12 years old.
When you find out your child has a disability, you may deal with a variety of feelings, including feeling angry, overwhelmed, and frustrated. This frustration increases when you realize your insurance, in some cases, may not cover many of the therapies that you need.
If you find yourself facing a special needs diagnosis, there are several steps you can take to make sure your child gets the help he needs without breaking the bank.
The first thing you need to do is contact the insurance to see what they will and will not cover. This varies widely depending on the diagnosis and insurance company. If your child has a relatively common condition such as autism, the insurance company may have a separate department specifically to address and handle your child’s care and condition.
You may also ask if they have any specialists who can work with you to help you find the right therapist that is covered by insurance.
Ask About The Codes Insurance Covers
Insurance can be notoriously picky for what they cover and don’t cover. Often, it’s simply a matter of using the right billing code. If you have a therapist who is experienced with your insurance company, she may already know what code to use for coverage. However, you may need to also talk to the insurance company. For autism, autism itself may not be covered, but a condition related to autism such as speech and communication issues may be covered.
Ask For a Discount From the Care Provider
If your insurance won’t cover the therapy you need, see if the therapist you want to work with will offer you a discount. Often therapists have a certain rate for insurance; the insurance then gets a discount, so the rate the insurance pays the therapist is much lower. See if you can get a discount for paying cash. Your therapist won’t have to fill out the insurance paperwork, so you’re saving the therapist time behind the scenes outside of therapy.
Connect with Others
If your insurance won’t pay for the condition and you don’t have the money to pay out of pocket, try to connect with others whose children have the same condition yours does. They may know tips to help you. For instance, many states have a separate department that handles autism. If your child is diagnosed as autistic, you can apply to the state to cover therapy. The state will also examine your child and decide if the child’s autism is severe enough to cover; if so, they will pay for the required therapies.
Seek Help with the Schools
Another great place to look is to the public schools. Two of my children had speech issues. Even though we homeschool, they received speech therapy for free from the schools. If your child is enrolled in school, you may find even more services are available to him.
If your child gets a special needs diagnosis, you will be facing a steep learning curve. However, with guidance and perseverance, you can get your child the therapy he needs.
Does your child have a special need? If so, what other suggestions would you add to this list?