My daughter was evaluated for speech delay...?

Question

But now the dumbass insurance company will not cover it!! What do we do now?? She is 17 mos old and has a significant delay ( 12 mo level) any suggestions?

I should add she does have Epilepsy but her docs are not sure if it is related.

Answer 1

Like others have said, you should contact Early Intervention Services in your state. You can find them in the phone book. The evaluation and services are free. Contacting Easter Seals is a great idea too.

I'm not sure how it works, but I know each Insurance company usually has an "appeals" process. They might want more information or even a specific diagnosis to approve the therapy (which I think is ridiculous!).

I know I've just repeated almost everything everyone else has mentioned; but I wanted to make you aware of a support group for parents of children with disabilities and special needs. There are parents there that have been through fights with insurance companies that may be able to help you. There are also parents there who have children with seizures, Epilepsy, and speech delays. I thought you might be interested in the emotional support as well as the information. The address is: www.specialparent.org

I wish you luck with Early Intervention and the Insurance company.

Answer 2

I don't think you can argue with the insurance company if you didn't get your visit covered ahead of time, but you can pursue the problem through your state program for children. They will come out and evaluate her at your home for free and if she's delayed enough (I think by 33%) they will cover her through a state program for early intervention. In my state it is called Babies Can't Wait, but it may be called something else in your state. Try searching with a search engine for early intervention for babies.

As far as covering the visit you already had, you may try having your pediatrician write a letter to the insurance company and they may cover some of it. If that doesn't work, ask the person who did the evaluation that isn't covered how you can have your bill lowered since insurance isn't paying. Chances are, they will knock something off your bill. Good luck.

Answer 3

Contact your local school district to have her assessed by a Regional Center. Since she has a current evaluation already, she should be able to easily qualify for services. Services offered through Regional Centers (under age 3) are free. She will have a worker, who will evaluate her needs and write an IFSP plan (Individual Family Service Plan) with you. Most insurances will not cover services, but you can get them for free from the school district and Regional Centers. The sooner you can get services started, the sooner you can start making headway. In the meantime, you can help by starting to use sign language with your daughter. Signing helps because it is easier to do and gives your daughter a way to express herself. You can also make picture cards. Take digital photos (or even regular ones) of things she likes to eat, drink, play with and do during the day, laminate them, and put magnets on the back to keep on your fridge. That way, you can ask what she wants and she has the success of being able to communicate it. These are probably some of the ideas that the worker will give you to help with her speech as well. Good luck!

Answer 4

Try finding out if your state has an early intervention program (I believe most states do.) I contract with my state's program for physical therapy and the program is free for kids age 0-3 if they qualify with a delay or a medical diagnosis. It sounds like your daughter has enough of a delay that she would qualify. Contact your pediatrician or your local Parents as Teachers program to see how to get referral into the program.
Good luck to you and your daughter.

Answer 5

Early intervention is very important.

Is it possible to switch insurance? If not, I would get the treatment and maybe consult a lawyer to see if the insurance company is just screwing with you. (Most lawyers will talk to you for free to find out if you have a case or not)

Also there may be free government programs like "head start" that can help you out.

But no matter what it is very important to get the therapy.

Answer 6

I suggest you contact your local Easter Seals - my son went to their preschool (he is not delayed) and they have some extremely talented teachers that work with children that have a variety of special needs- from speech issues to autism and more. They take children older then 6 weeks. You can even send them for just p/t.

Then you can itemize your taxes and get most of the cost refunded.

Answer 7

Contact your school district. There should be an early intervention (0-3) program in your area. The school should tell you how to contact them. In our area it's with the adult special help program. It's called Self Help in our county and Krieder in the next county. If there is an Easter Seals near you, they could also help you out.

Answer 8

I do not know were you live but I live in California. My son has a speech impediment that was diagnosed by his pediatrician. The state offered many types of programs for our son and they all were free, from daycare to preschool. He was greatly helped and now he is in 1st grade and has very little trouble being understood.

Answer 9

The Scottish Rite has lots of services for children. They test children's hearing, eyesight, speech for free and treat any problems also at no charge. If the one in your area doesn't ask them who does, they might know.
Get the number from the phone book. I may not have spelled "Rite" correctly. Also try "Right" and "Richt". I know it has a strange spelling.

Answer 10

Get your doctor to help you out.