My Christmas Wish

When we got our autism diagnosis, I called our insurance company to find out what our benefits were.

Do we get the $36,000 a year in autism therapy benefits as out lined under Illinois law, Insurance Company?

No. Your policy was written in New York. Our insurance company is under no obligation under that law.

Does our policy cover Applied Behavioral Analysis, the evidence-based go-to behavior modification therapy?

No, your policy does not cover ABA.

Insurance Company, will you approve weekly speech and occupational therapies for the rest of the year?

That last one took a week or two, but they got back to me.

Yes, Mrs. Judy. We can authorize those visits.

Hallelujah, I cheered. At least we’ve got that.

We burned though those visits and then some, but the checks stopped coming in.

But Insurance Company, you authorized these visits, I said.

Your plan doesn’t cover them.

But you authorized the visits!

Your plan doesn’t cover them.

But I called Care Coodination and—

Care Coordination doesn’t look at your plan when they approve your visits. I see here that they authorized your visits, but it’s your responsibility to then review your plan, which you can see only covers 20 visits.

That doesn’t make any sense. Why are they called Care Coordination if they don’t coordinate?

Is there anything else I can do for you?

Blink.

Pause, pause.

Blink.

No. No thank you, Insurance Company. I hope you have a nice holiday season. I hope your CEO has a merry Christmas in Aspen or Switzerland or wherever people who get rich by denying medical coverage to children go to celebrate their temendous wealth. I hope that none of you ever has a child who can be helped by a proven and conventional therapy, only to have your insurance deny you simply because they can. I hope that you don’t have to go through your budget to try and find an extra $20,000 next year in order to provide your child with the minimum level of care. I hope that your sleep is sweet and undisturbed by worry about what’s going to happen to your child if you can no longer afford the things he needs.

Insurance Company, I hope that everyone in your life does what they say they are going to do, that they keep their promises. Your husband, say. Your boss. Your mother, your father. Your health insurance company. I hope that you aren’t betrayed by anyone who promises help that never comes.

I hope that you enjoy the new year without any guilt weighing you down, Insurance Company—guilt that you’ve let your family down by believing in false promises, that you’ve spent thousands of dollars you don’t have and all the bills are past due.

I hope all of those things for you and more, Insurance Company. I hope you have a very merry Christmas, indeed.

Comments

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Your post is super similar to one of my recent ones:
http://chasingnathan.blogspot.com/2011/12/paritywhat-parity.html ....it all comes down to their bottom line. so infuriating!!

Posted by: Jennifer Garrison | 12/23/2011 at 12:42 PM