Raising early intervention and autism awareness through our amazing journey

Denied, denied, denied..

So we had yet another screening/assessment done for our little man. This one was to determine if he would be eligible to receive government funding to help with the significant expenses of his therapy. The therapy would include speech, OT, PT, and ABA therapy, in which we had medical prescriptions for these therapies. Our son’s developmental pediatrician states that “I don’t have a patient that doesn’t have it” regarding this waiver. So we were pretty optimistic that he would be granted the waiver.

We got the letter last week explaining their decision. Our son met the “assistance for daily living” criteria. He also met the “medical” criteria. However, he was denied because he was not found to be “at imminent risk for a nursing facility”.

We are now beginning an appeals process. We aren’t sure how long this will take, or the cost of the appeal itself, but our son needs help. It has been found that early diagnosis for autism is needed for a positive prognosis, but where is the funding? So, I guess we will be seeing a lot of children who have early diagnosis (16-36 months is the “best time” to diagnose) and a lot of children without help…unless they are at risk to be hospitalized. So the children that are on the milder side can’t get help. Unbelievable.

Additionally, we were denied by insurance for the genetic testing..twice. We appealed and they stood firm to their decision. Genetic testing would not only allow us to find a genetic link to his autism, but would help in determining the correct type of treatment that he would need.

We have another assessment with the county next month to determine if he will qualify for public school services. This would be a pre-k program he would start at two and a half. I am beyond heartbroken.  BUT this little guy keeps me smiling (AND on my toes), he’s happy and healthy.  Image

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