health insurance rant

[MizMissy]

Sorry, but I have to vent a bit. My DS(8) has speech delay/communication disorder (he did not speak until he was over 3) and has been in speech therapy since he was 3. At the beginning, my insurance covered speech therapy, but very few visits. Then, when he started school, we had him evaluated and he has an IEP through the school board (he's in private school, but a speech therapist from the school board provides him therapy at his school during school).

The last year or so, I have not been very happy with the school board speech therapist. I made many requests to her to send extra work home with him for us to continue work at home and she ignored my requests. DS really did not even know her name. And, because it is provided by the school, there is no therapy offered in the summer for him. I decided to move him back to private speech therapy because I would like him to receive therapy this summer and I feel that the therapy provided by the school board is not sufficient and is starting to interfere too much with his school day.

Now the rant .... my health insurance does not cover speech therapy for him. It only covers therapy for "rehab" from an injury (such as an accident or stroke). Same thing with physical and occupational therapy. This is ridiculous. In addition to DS's speech issues, he also had some autistic tendencies as a toddler and other issues so he was in occupational therapy for a while also. Basically, any of those services that were absolutely necessary for him as a toddler would not have been covered under my current insurance. Maybe because the state provides services for children on the spectrum?? I don't know. It took a while for me to decide to have an IEP for DS because I never wanted him labelled. Still, I thought my old insurance was cruddy ... this one is worse!

It's just frustrating to pay for insurance, to have a high deductible plan that requires me to basically pay out of pocket (through my health savings account, but still paid by me) for the great majority of my family's health care until I meet my deductible (I actually did not meet my deductible the last two years, which is good because it means we are pretty healthy, but still!). Now, I'm going to have all of these expenses out of pocket and none of it even counts towards my deductible!! Arrrgghh. So very frustrating. Anyway, fortunately, we can pay for the care my DS needs, but it is still very aggravating to have worthless insurance coverage on top of outrageous premiums.

[Tinkerfreak]

Don't get me started in health insurance. I pay over $500 dollars a month and have a $15,000. deductible per person in my family. It just keeps going up.

[cajunprincess]

Don't get me started in health insurance. I pay over $500 dollars a month and have a $15,000. deductible per person in my family. It just keeps going up.

$15,000?????? Is this a misprint??? I promise to never complain about my $300 deductible again. The most I ever pay out of pocket ever year is $3000. No matter what goes over that. And I pay less than $200 a month for my family of 4!

[KODABEAR]

Many years ago our son was born with the same type problem. At that time the " Easter Seal's" project paid for his therapy. Check around maybe there is an org. for childrens health that might be able to give assistance.

[TheVBs]

I definitely feel your pain. We didn't know how good we used to have it with insurance. Remember $10 office visit copays and $5 prescriptions? It's insane how much things cost. Our DD10 needs to have an MRI next spring (she's totally fine, it's just a follow up on something to be safe!), and I was floored when I found out the price tag!

[DizneyRox]

If health insurance is too expensive and not worth it, you can always pay OOP for all of your health care needs. There is nothing in health insurance that prevents people from seeking the care they require.

Please don't confuse health care with health insurance. Health Insurance is a business opportunity, it's not a right (yet). If it becomes a right, the landscape of health care, in the US anyway, will drastically change. Not sure if it will be for the better or worse, the jury is still out on that.

[DisneyMom12]

What about through the public school district you live in? When my son was is private school, the pubic school district was responsible for services. I was able to choose to use the district, or private.

[A Big Kid]

Don't get me started in health insurance. I pay over $500 dollars a month and have a $15,000. deductible per person in my family. It just keeps going up.

Just wait until it is free. Then it will get REALLY expensive.

[Tinkerfreak]

$15,000?????? Is this a misprint??? I promise to never complain about my $300 deductible again. The most I ever pay out of pocket ever year is $3000. No matter what goes over that. And I pay less than $200 a month for my family of 4!

I wish it was a misprint but it isn't. We own a construction company and are self employed. I do work as a pharmacy tech. but only part time.

[Jillirose]

In our area, the public school provides services to private/parochial schools that are registered with the state. So, our speech and language pathologist would serve any student at the parochial school that was eligible. Just FYI, you may want to inquire with your intermediate school district or educational service district (probably the agency that initially evaluated your son).

[DVC2004]

I know it's frustrating. My older son has an autistic spectrum disorder. When he was small and going to school he was having all sorts of issues and hadn't been diagnosed, only as learning disabled. The school had already placed him in a special class but for something else, they didn't have his diagnosis right and turned out were not following the IEP they had put in place (which I found out much later after they admitted they hadn't been providing him speech therapy at all) . He was overwhelmed in a large class and didn't understand directions being given to him. He was in 1st grade. I asked my doctors several times for a referral based on the issues we were having. They said there was nothing wrong with him, despite all the issues I had brought up (delayed speech among other things). The last straw was when the school basically kicked him out and said you need to get something from the doctor in order for him to be tested further or he can't come back, because we can't educate him. They had been calling me every day to come pick him up. I went to the Dr. and she blew it off, said go get his eyes checked. I told her both his eyes and ears had been checked just 2 months ago and asked her to please call the school so she could hear from his teachers. She refused to call and refused help. She told me she wouldn't give me any referral because he didn't need one. I called the insurance company and although they were sympathetic, they told me it was all on the dr. Long story short I paid out of pocket to get my son tested so then he could be tested by the school to be placed in the appropriate class and education plan. I could not believe what we had to go through. If my child was blind instead I guess he would have been treated differently. There is still alot of frustration when trying to get care and therapy for developmentally delayed, autistic, and autistic spectrum children.

[MizMissy]

If health insurance is too expensive and not worth it, you can always pay OOP for all of your health care needs. There is nothing in health insurance that prevents people from seeking the care they require.

Please don't confuse health care with health insurance. Health Insurance is a business opportunity, it's not a right (yet). If it becomes a right, the landscape of health care, in the US anyway, will drastically change. Not sure if it will be for the better or worse, the jury is still out on that.

I know health care coverage is a choice for me. My choice is to basically have health insurance more for catastrophic coverage and as a way of trying to budget my health care costs during the year. I have a high deductible plan so I know that the majority of my family's health care costs during the year will be paid OOP through my HSA. My aggravation is in the fact that the health insurance carrier continues to charge more for premiums and then change their plan on what is covered and not. So, with the speech therapy costs not being covered, I do not even receive credit on my deductible ... all of the these are OOP costs that are in addition to what I have budgeted for health care. Now I have to increase my budget and increase my HSA funding.

I know, I know ... "that's life." I really did not have a point in my post other than to vent to someone other than my DH. And, I thank you guys for letting me vent. It helps a little to type out my frustrations.

[MizMissy]

In our area, the public school provides services to private/parochial schools that are registered with the state. So, our speech and language pathologist would serve any student at the parochial school that was eligible. Just FYI, you may want to inquire with your intermediate school district or educational service district (probably the agency that initially evaluated your son).

Thanks. He is receiving speech therapy during the school year through the school board (I don't call it free because my tax dollars definitely cover it). However, he needs additional therapy in the summer - which they do not provide, at least not in DS's case - and I have not been happy with the level of therapy being provided by the school board. The therapist really is not very good at her job. It's my choice to move him back to private therapy in order to receive better care.

[VWL Mom]

When my son was young he had auditory processing and needed a speech therapy program over the summer (school district had one during the year). I spoke with the therapist and told her it was not covered by our insurance and she cut her rates for me. Worth asking about.

[MNNHFLTX]

I wish it was a misprint but it isn't. We own a construction company and are self employed. I do work as a pharmacy tech. but only part time.

Since you are a pharmacy tech, don't ever hesitate to ask your clinics, doctors or other healthcare (and medical equipment) providers if they offer a professional discount. Not all do, but you might luck out and cut your OOP expenses a bit.