Praise Report: Our insurance will start covering Occupational Therapy for Autism Spectrum Disorder in January 2013!!!!
Children with ASD often suffer from Sensory Integration Disorder. They need a strong sensory diet to help them manage their sensory issues, and an Occupational Therapist can help to identify the areas of concern and develop an appropriate sensory diet.
When Tyler was first diagnosed with Asperger's in December 2010, one of the items on our care list was to take him to an Occupational Therapist. He had an evaluation done in February 2011, which identified numerous sensory issues, and we proceeded to set up a schedule of weekly visits.
However, there was a hiccup with our insurance. We had been led to believe from the medical office that our insurance would cover the visits; in fact, they paid for about ten of them. Then, the insurance company discovered their error and quit paying, leaving us with the bill for the final three or four (thank God that they did not require repayment for the other that they did pay for!). We appealed, but it was denied based on the grounds that there was no clear evidence that occupational therapy helps ASD children.
We were so disappointed because Tyler loved going to therapy. Craig, the OT, had a big platform swing hanging from the ceiling and Tyler spent a lot of time in that swing. One of the things he had to do was to lay on his stomach and Craig would throw bean bags. Tyler would have to maneuver the swing to where he could pick up the bean bags. Lots of fun!
But, we couldn't take him anymore when the insurance stopped paying because the sessions are just too expensive. I've tried to increase his sensory diet at home (shaving cream, anyone?) but we don't have all of the equipment and I'm not trained as I should be.
About a week ago, Jim called me from work and said "Guess what? We just got out of a benefit meeting and they said that they are going to start covering ASD!"
We weren't quite sure what that meant, so when he got home we looked up the new benefits guide and sure enough, it says that they will start covering occupational therapy for ASD!
I am so thankful for this change. I have been praying because I feel like we came to a stand still and I wasn't sure what, if anything, God wanted us to do next. Thank God for open doors!!!