United Brachial Plexus Network, Inc.

I can't belive as an OT I am facing this situation but here I am. Aidan had his TTilt in Feb. In June he lost his rehab OT services through his insurance. We appealed they still won't provide them. He's about to lose his services from the County (Early Intervention) even after recommendations from his doctor and therapists. Because he has made progress (not yet to age level though) they are going to discontinue. I'm in the school system and we work differently than this. I have threatened lawyers, etc (usually does the trick for us!) Nothing is working. Any ideas? I'm at a loss, I can't believe they won't provide him something he so desperately needs!

It's a horrible thing when services go away. When Maia met the end of her benefits I just had to do it all myself which wasn't a problem really because I was doing it all along anyway at home daily. I have three therapists who worked with Maia in the past and know Maia very well and I can bounce things off and create home plans with any of them. And all the activities I have Maia in, works on different areas of need (without her knowing it!) --- that is by far the BEST way to handle things when they get a bit older (5+)

Your little guy is so lucky - he's truly ahead of the game with Mommy being an OT! I'm sure that Cindy will help you work out a home plan. Do you have a copy of the post surgery protocols? If not email Cindy and she'll send you a copy. (cindy1otr@aol.com)

Does your state offer a insurance assistance program? In Michigan we have a program called Children's special health care services. They pick up the costs for medical bills related to the injury that the insurance doesn't cover. I think many states offer programs similar to this. I hope you can find the help you need. It's such a shame that the insurance companies can do that to these little ones.

What about applying for NY State Medicaid Waiver Services. Contact your local OMRDD office or ask your current coordinator for Early Intervention about this. You can have private insurance and still have this service. The medicaide waiver services can get your child medicaid insurance as a secondary insurance which could pay for the OT! This is NOT based on income, but rather on the child's disability. The waiver service can also qualify you for other things such as family respite, mileage reimbursement, reimbursement for hotels during travel to out of area doctor visits, reimbursement for therapy toys, assistance in purchasing durable medical equipment, and educational items. Feel free to email me if you want more information, but we have utilized this service as well in NY State. Don't take no for an answer!

Tanya in NY
Amber's Mom, ROBPI, almost 6 years old

http://www.health.state.ny.us/health_ca ... /omrdd.htm

Website for NY State OMRDD / Medicaid Waiver