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Forum
-> Household Management
-> Finances
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amother
Orange
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 Tue, Oct 24 2017, 9:35 pm
My son gets OT for a lot of neurological issues that result in him being a sensory mess. I first went through my insurance and there was only one place they covered so we went there for 10 sessions, and it didn't help him at all. We found a much better place and they said they don't cover it, so we've been paying, but it's very expensive and we're running out of money. Any advice on dealing with the insurance company??
(Or other ways to pay for therapy also welcome)!!
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amother
Periwinkle
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Tue, Oct 24 2017, 9:46 pm
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I'm in the same boat - I think we're stuck.
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amother
Mauve
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Tue, Oct 24 2017, 9:46 pm
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I don't think there is any way to talk them into covering another therapist, but the way it works for us, is that after we meet our deductible, we can submit invoices for reimbursements.
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Happydance
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Tue, Oct 24 2017, 10:45 pm
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Can u get a letter of medical necessity from doc?
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Mommyg8
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Tue, Oct 24 2017, 10:48 pm
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Just wondering, it might depend on how old the child is, and where you live, but some communities have EI and some also have programs for 3-5 year olds. That might be something to look into if your insurance has run out.
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animeme
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Tue, Oct 24 2017, 11:46 pm
Yes to submitting for out of network coverage. Some places will do it for you- you can ask. Call your insurance company to check what your out of network benefits are.
Also, there's something called a network gap exception that can sometimes work, if you can show that the in-network place can't serve you (for example, can't get you in for enough hours, or at the time you need.)
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loveit
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Wed, Oct 25 2017, 1:10 am
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What about your closest JFS? They offer sliding scales for OT and ST, depending on your area they may even come to your child's school so you don't even have to go anywhere
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amother
Oak
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Wed, Oct 25 2017, 9:03 am
| amother wrote: | My son gets OT for a lot of neurological issues that result in him being a sensory mess. I first went through my insurance and there was only one place they covered so we went there for 10 sessions, and it didn't help him at all. We found a much better place and they said they don't cover it, so we've been paying, but it's very expensive and we're running out of money. Any advice on dealing with the insurance company??
(Or other ways to pay for therapy also welcome)!! |
I was in the same situation but for different type of therapy.
I was helped by an agency that fights such things with your insurance.
Advanced Advocacy Group, Inc.
Phone (845) 781-7325 x101
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