Anyone getting priced out of intervention?

[Anonymous]

Anonymous wrote:To 15:05...ohhhhhh your ST is in network. That makes a HUGE difference! Out of network is a whole different story with ST. For some reason it is easy with OON OT, but not ST. Where did you find an in-network ST?

You know even our co-pays are going up right? Am curious to see if reimbursements go down.

We used an out of network provider for ST. It was Skillbuilders. granted, the reimbursement was not that much. I think we got back $40 for each $110 session (so we paid about $70), but it was something. We have federal BCBS. We use in network for OT (Good Beginnings) and pay $20 a session -- that has helped tremendously (and we ended up with a much better therapist when we switched there).

[Anonymous]

Anonymous wrote:This is a great juncture to point out that there is a biiig divide between what the Feds get in their insurance and what the rest of us get. Collective bargaining and all.
I have regular old NOT Federal Employee's BC/BS and it covers not a single cent for any OT or ST. (unless the insured is in a bad accident or something.)

That was also true when we had Aetna like 10:44.

I used to be a Fed and now I'm not and the difference in coverage is stark, esp. for all those things that are not hit-you-over-the-head emergencies.

Federal employees can't bargain salaries or insurance benefits.

And FEP-Blue isn't any different than regular BCBS coverage.

[Anonymous]

Just to be clear there is no one thing called "fed insurance." I do have federal BCBS and, so far, have been happy with the in-network coverage for OT and PT, but BCBS is just one plan that feds can choose to join and benefits completely vary plan to plan. The premiums for BCBS are really high and we would have switched but for this therapy issue. That said, I'm not so happy with the in network OT we are seeing. I think we would be better off with someone else but can't justify the price differential.

[Anonymous]

Skillbuilders is now $120 an hour. Had no idea Good Beginnings was in network?!!

[Anonymous]

Anonymous wrote:Are there really insurance plans that cover OT and Speech. My insurance (Aetna) excludes anything related to a developmental delay and autism, and I assumed that all insurance plans did the same.

Aetna is really one of the worst. When DH was in private practice it was always a nightmare of red tape to get them to pay for anything except a catastrophic coverage situation--Kaiser was similar. BXBS is great for some things and not others--there's the FEP plan and PPO's which are high premium and they cover alot. America is going to slowly become like UK where the rich go to Harley Street for the real Docs and the unwashed masses have to take what they can get in Natinal Health.

No one wants to bite the bullet and make a fair system because of the heterogeneity of the population in America, blah, blah, blah.