I've spent my day on the phone with various insurance providers, searching for a solution to this problem. I spoke with several companies and provides before finally calling the High Risk Pool. This is the information I received.
There are three different plans, two that fit our budget perfectly.
They cover medical expenses and have reasonable co-pays, even for specialist visits.
They cover therapeutic needs, even past age 3.
They cover her on going hearing tests, although not her hearing aids. No big deal, we only got $500 from our current insurance to help with her aid. We can handle paying the full amount out of pocket when it comes time again.
I explained that she has no official diagnosis and asked about eligibility.
She said that if KayTar was either denied coverage previously or was accepted, with the exclusion of some of her needs she is eligible.
I have an email from the agency we used to apply for insurances stating that they cannot cover her therapeutic needs. I would just have to get that on their letterhead and we are in.
She asked, "Are you or your husband employed? Does his employer offer group coverage?"
Yes. He is. They do. And it sucks and costs your YEARLY DEDUCTIBLE every MONTH.
I asked, "If his group coverage does not cover some of her needs, can we still qualify?"
She put me on hold for a few minutes and came back with a voice filled with apologies. Any group coverage, ANY group coverage. Expensive, awful, worthless, ANY. Any group insurance is a deal breaker.
And so we have one less option. The one option that we thought might work the best.
It shouldn't be this hard.
I am so sorry, yet again, for this set back.
OH, honey. It totally shouldn't be. That is terrible and I am so sorry you have this stress on top of everything.
Oh Kyla, it should not be this hard.
I turned down my dream job in Ann Arbour Michigan ten years ago when then sent me the health package and I freaked out. My supposed-to-be boss called me a socialist. She was right.
I think we have all offered to sponsor you but you shouldn't have to leave home. I put the smarties in the mail today so maybe you'll get deported. Ask for my brother James at immigration. We'll set you up real nice here.
OH, I am so sorry. It shouldn't be like this.
It's not right. It really should be this hard to provide for the needs of one little girl. I'm so sorry!
I am so upset on your behalf. Kaytar's behalf.
Using My Words
Shit. Shit. Shit. Shit.
Seriously, have you considered emigration? I know that is an awful question to pose in all seriousness especially given family and home and all that but it seems to me that if you're country sells you so far short...
So not right.
No, no, no, it shouldn't be this hard.
I can't begin to imagine how frustrated you must feel and am so sorry for it. But, I *do* have a shiny new (barely even used)navy blue oticon digital hearing aid that we can send to Kaytar when the time comes. $1500 hearing aid baby! (We got it covered through our state health dept. as our insurance doesn't pay for hearing aids)
You're right, it shouldn't be that hard and Americans have to stand up and demand universal health care. It's a disgrace.
i read this earlier and got so angry that i had to leave it and come back.
this simple necessity. and yet you have to struggle so damn hard.
this makes me so angry and i wish i knew what i could do about it. Let's ALL write Michael Moore. tell me what we can do. i just don't know and this is so utterly ridiculous.
I want to help so much. So sorry.
Excuse me while I curse a second, but that is so fucked up. I am so sorry.
Oh this makes me so angry!!! The shitty group insurance disqualifies you from good private insurance and the taxes disqualify you from government insurance. This should not be.
no it shouldn't, it just shouldn't
I am so sorry Kyla
oh and I'll sponsor your family too (but you'll want to stay with Lisa B because I'm positive her diggs are waaaaaaay better than mine - and cleaner too!).
I am so sorry Kyla.
It shouldn't be this hard.
Move to my town. Your husband can work at the same place as my husband and you too can experience the same peace that comes with a $200/month mortgage and universal health care.
Oh, Kyla. That SO sucks!
Damn your health care system.
sorry. but damn it.
I have similar insurance woes with my kids... Do you live in Calif? Maybe you can get OT and feeding therapy through the CCS Medical Therapy program. It's good for conditions that are medical in nature. See this link: http://www.dhs.ca.gov/pcfh/cms/ccs/mtp.htm#MTUDir
Post a Comment