I was informed last week that my son’s Insurance authorized his Speech Therapy. Good.
But they decided to cut his current sessions in half. Bad.
ROAR!!
Several people tried to convince me that this was actually a good thing. They were happy that he was given “twice the amount than they usually approve,” so to them this was a major victory. It hardly seemed like a good situation to me.
They were removing him from his home environment and sticking him in a clinic.
How is this good for a child with chronic lung disease? The same child who had pneumonia 6 times last year. He’s not even two and a half and already they are messing with his services.
ROAR!!
I took a few days to step back from the situation and discuss it with various people before I made a decision on what action to take.
Choice 1: Deny the Ins. services. Try to convince the EI team that they should continue to cover this service twice a week for 60 minutes in our home. With this option I risk making the Ins. Co mad and they may NEVER again cover this service once he ages out of EI. Bad.
Choice 2: Accept the Ins. services no questions asked. Traipse him, his nurse & equipment 20 minutes away, twice a week for a 30 minute session. Bad.
Choice 3: Accept Ins. services, but go on record as not happy. Also convince ST office to combine 2-30 min. sessions into 1-60 minute sessions to eliminate risk of exposure to germs (aka: other possibly sick kids.) Good & Bad.
It was up to me to decide. Everyone cautioned me to choose wisely, because this could affect much more than just the present day situation.
Uh, no pressure or anything.
I have to be honest, this is where it sucks to be a single parent. I don’t have someone to bounce ideas off of or take up arms and join me in the fight.
I sensed myself getting weak and leaning heavily toward Choice 2 because I know I need to pick my battles. I just wasn’t sure if this was a battle worth fighting NOW or not.
After a week I decided it was not fair and I was going to fight it, I settled on Choice 3. At the very least I wanted it on his record that I did not agree with what they had offered. I figured they may or may not change their minds, but at least I will have tried. So lil’ ole David was going into battle with bureaucratic Goliath.
I called our EI coordinator, whom I really admire. Her advice as a parent is direct and right on target. Her advice as a coordinator is the company line, but she always let’s me know that I have options, they may be risky but they do exist.
I started our conversation by saying, What am I going to do without you to talk to when we age out of EI? And this is why I love her. ‘You can still call me and I will help guide you,’ she replied.
Then she said, ‘I have good news for you. Our team met with a new director yesterday and they approved ALL services for another 4 months. ALL including Speech Therapy.’
That was Choice 1!
I laughed and told her I was calling to tell her I was ready to fight.
So I’ve put my gloves away for another day.
Always nice to avoid a fight isn’t it?
Janis chronicles Austin’s life and medical journey at Sneak Peek At Me. She is an advocate for medically fragile children and families living with a rare disease diagnosis.