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Joined: Jun 2016
Posts: 10
Junior Member
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OP
Junior Member
Joined: Jun 2016
Posts: 10 |
Is your child accelerated somehow? Why is a 7 year old doing multiplication and division if he struggles with it to such a degree? He is not accelerated. His entire 2nd grade class is doing the same work. He's in a public charter school. Unfortunately, I can't answer why he's doing it when he's struggling. Both he and the teacher have confirmed that he works much more slowly in math than other children, and is always still working when all of the other children have completed their work.
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Joined: Jun 2016
Posts: 10
Junior Member
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OP
Junior Member
Joined: Jun 2016
Posts: 10 |
Thanks very much, aeh, for your very informative and helpful feedback. You may wish to consider further assessment by a hospital/clinic-based team, who would be the most likely to have experience with an ADOS-2. Other members of the evaluation team that might be valuable may include a speech language pathologist and an occupational therapist. Yes, I think this is what I'm going to try next. Unfortunately, I won't be able to do this until next year due to finances and also their long waiting list. Depending on your insurance, you may be able to receive full or partial coverage for this with a referral from your primary care doc. My insurance does not cover any autism-related services or evaluations, whatsoever. Because of this, I've used my flex account to pay for evaluations, but I've used all of those funds already for this year. Regardless, I do appreciate your pointing this out since it's important that people know it can be covered. Thanks again!
Last edited by Ophelia; 06/26/16 08:39 AM.
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Joined: Jun 2016
Posts: 10
Junior Member
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OP
Junior Member
Joined: Jun 2016
Posts: 10 |
In addition, if you go through a hospital for testing, they can likely advise you about funding sources other than your insurance. Some states and/or counties have funding programs that specifically fund testing for developmental disabilities. I was not aware of this. How wonderful! Thanks very much 
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Joined: Sep 2011
Posts: 3,363
Member
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Member
Joined: Sep 2011
Posts: 3,363 |
My insurance does not cover any autism-related services or evaluations, whatsoever. Ophelia, I'm guessing you've already tried this, but just in case - with some insurance policies, the code used for a referral makes the difference in coverage. For instance, you're looking for an evaluation to look into autism, but your pediatrician might make the referral under a code that doesn't specifically mention autism. I'm sorry I'm not very well-versed at explaining this, but fwiw when we ran into issues like this sometimes our ped's office was able to help, sometimes the office offering the eval or therapy was able to help with codes. Best wishes, polarbear
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Joined: Jun 2016
Posts: 10
Junior Member
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OP
Junior Member
Joined: Jun 2016
Posts: 10 |
I responded to everyone yesterday, but apparently, I did something wrong because they never appeared. So, I'll be back later this evening to try again.
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Joined: Jun 2016
Posts: 10
Junior Member
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OP
Junior Member
Joined: Jun 2016
Posts: 10 |
Ophelia, I'm guessing you've already tried this, but just in case - with some insurance policies, the code used for a referral makes the difference in coverage. For instance, you're looking for an evaluation to look into autism, but your pediatrician might make the referral under a code that doesn't specifically mention autism. I'm sorry I'm not very well-versed at explaining this, but fwiw when we ran into issues like this sometimes our ped's office was able to help, sometimes the office offering the eval or therapy was able to help with codes. My insurance usually doesn't require referrals for coverage, but I can try it that way and see if it makes a difference. My understanding after speaking with the insurance company previously is that regardless of the reason for the evaluation, if the diagnosis comes back as ASD related, they will not cover the evaluation. This seems incredibly wrong to me. I wouldn't want to be the parent who's not expecting an ASD diagnosis, receive the diagnosis, and then have to unexpectedly cover the cost of the evaluation.  So, I will remember what you said when I contact the hospital, and will ask them about it. Thank you
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Joined: Jun 2016
Posts: 10
Junior Member
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OP
Junior Member
Joined: Jun 2016
Posts: 10 |
With the Affordable Care Act, habilitation services are now covered (to varying extents), so if you have not checked your insurance coverage recently, you may find that autism is covered.
You can google your state and see what your standards are for private insurance We have private insurance via my husband, and his insurance was "grandfathered." His employer opted out of autism coverage, and since changing jobs is not an option, I'm not sure we have a way around it.  I have checked into the insurance portion quite a bit, and even asked the employer to opt in, but that didn't work either. Thanks for the heads up, anyway.
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