BellaOnline Forums Health and Fitness Autism Spectrum Disorders Health Insurance for Autistic children

This is my first post! My 11 year old daughter was diagnosed with autism spectrum disorder (asperger's) in 2005. We recently changed insurance companies and our agent forgot to add our daughter to the policy. In the past two months, Nina (my daughter) has begun taking Lexapro for her anxiety. My agent says there's no way our insurance will cover her and suggests we go with a separate policy for her under Blue Cross. I am so upset over this. What type of insurance do you have? What does it cover? Cost? Any advice you have would be greatly appreciated. Thank you.

If it was the agent that forgot to add your child - then I would fight tooth and nail over her getting coverage.

What insurance company do you use?

We use BCBS PPO - and it has been a pretty good insruance company for us as far as doctors and hospitals go. The drug coverage company is Caremark - I honestly do not know if that is an arm of BCBS or not.

Also, why did you change insurance agencies? Was it because of a job move? If so, then they HAVE to cover her. But if it was just because you wanted a better rate, you might have a little harder time.

Does the agent you are working with work directly for one of the insurance agencies? If so - he is looking out for what is best for his company.

It might be best to see if you have a local autism advocacy group in your area. I found one by googling "autism support group gwinett county" and found a VERY large one near me that has lots of active people - some even active in legslation here in Georgia.

Also, here is an article that "Autism Speaks" wrote to propose the growing problem of insurance and autism here in America. It is a little lengthy - but it might give you a few ideas of where to get started in your state.

Autism Speaks article on insurance

Hi there and welcome to the forum. Both my kids get SSI so they have Medical, some states call it Medicaid. A separate policy would be very expensive. What about a drug discount card? When having issues with my insurace I used AAA discount card for my prescriptions.

We are new to the country. My brother is autistic and 19 years old now. We are looking for a useful insurance plan but i couldn't exaclty understand how it works. I researched for BCBS' i heard it is one of the best companies in NJ. Is PPO plan you told about a dental coverage? What should i do to get an insurance for my brother and my family? Can you offer a plan from BCBS also? If anyone can give me an information about the process and deductible and coverage things, i will be appriciated. Because in my country even private insurance system works totally different. For example there is no deductible provision for the policies.

No, the PPO plan is not dental (our dental is through Metlife - I'm hnot even sure BCBS offers dental...)

PPO is short for Preferred Provider Option; it means there is a list of doctors, clinics and hospitals that you can choose from to use. We like this because we can choose which docs we want to use as opposed to having to go to a certain clinic that is chosen for us. We have a $200/person or $1000/family deductible and a 10% co-pay as long as we use someone in the PPO network, and a 20% deductible if they are out of network.

But we get our medical insurance through my husband's workplace. I think we had the choice of 2 or 3 different plans to choose from, and this fit us best.

I am not sure how BCBS works if you are doing it privately. I mean I'm sure it still functions the same way - but i have no idea of costs per month or anything. You would really need to speak with an insurance agent to get all of those particulars.

Do you know about Social Security? Are you his guardian or he is higher functioning and not in need of one? If he gets Social Security he would get state medi-Cal or Medicaid, depends on the state he resides in.

Good luck

Michelle, may I ask what kind of services you are receiving? We currently have BCBS (although ours is HMO). My son will be getting 1/2 hour of speech therapy twice a week, which is covered by the school system. However, I was wondering if our insurance would cover more.

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