My beautiful friend Tara blogged about her "Word-for-the-Year" a few weeks back. This word is to be sort of your "Focus" for the year. I told Tara that my word for the year was going to be "FIGHT". It seems to be all I do anymore with regard to Mason's Autism.
Fight - noun; a battle or combat.
We have been trying to get Mason some MUCH needed speech therapy for nearly a year now. Our insurance company (Cigna) has continually denied benefits. We have taken it to State level arguing that a Colorado state mandate rules that Autistic children under the age of five are legally entitled to speech therapy (up to 60 visits per year). Come to find out, OUR policy isn't subject to state mandates because of the way they are contracted with Gregg's employer. Well, back in Sept. I went to Gregg's employer (Big Ol' Hospital) and told them that their policy is not in state compliance and that my son is suffering for it. They agreed to change their policy beginning in 2009 so that Mason could get the speech therapy he needs. We thought that was fair and went ahead and footed the extraordinary bill for therapy from Sept - Dec. The first of January we put through the referrals for Mason to get speech therapy using this "new plan". We were DENIED stating the same reasons as before. Our plan had in fact NOT changed! I was unbelievably PISSED OFF at having been lied to by my husband's employers. I called said Big Hospital Employer and left a "Mommy Freak-Out" message on the head honcho's voice mail. At that point, I didn't care if Gregg got in trouble or faced reprocussions for my tyrade. They LIED to me and my son was going to suffer even LONGER for it!
Well, today I got a phone call from a big-wig at Cigna stating that our insurance policy has been changed and that Mason will be covered not ONLY for UNLIMITED visits of speech therapy but for ANY AND ALL AUTISM RELATED TREATMENTS!!!!!!!!!!!!!! This is unheard of in the state of Colorado. No insurance company in Colorado (to my knowledge) covers any autism related treatment because it's EXPENSIVE and you need a LOT of it. Some states require coverage for autism treatments, Colorado is not one of them.
The woman (big wig at the insurance company) told me that if ANYONE gave me any grief at all over billing, or benefits for ANY autism related treatments that I should call her directly and SHE would take care of it personally."Mason WILL be taken care of," she told me. She was so sweet, and so understanding and she was my saviour today. THANK YOU DORRIS!
This is the biggest, hugest most mind blowing "WIN" I could have imagined! I was fighting to get him speech therapy and we got him total autism coverage! We got him what THOUSANDS of children in this area and hundreds of thousands throughout the country are being denied. We can now get mason the help he needs, and the insurance is going to pay for it! (Well, most of it anyway!)
I have been floating on cloud nine all day, you could not possibly wipe this smile off of my face. A weight has been lifted and now I know that I AM doing all I possibly can for Mason and it feels DAMN GOOD!
Thanks for letting a proud mom gloat!