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[quote=Anonymous]DC has microcephaly and a diagnosed speech delay.  DC started receiving speech therapy through my county's early intervention program at 13 months old - DC is 19 months now.  I confirmed with my insurance (Federal Plan: Aetna Open Access HMO) that the speech therapy would be covered and initially the plan did pay for the service.  However, in June, without any notice to me, the plan stopped paying for the service.  Insurance now calls speech therapy 'experimental' based on his two diagnosis codes- speech delay and microcephaly- and they said they accidentally paid for the service initially.  I'm livid - the therapy is starting to work (DC is babbling finally and even has five words), and I don't want to stop.  However, this is a financial burden.

Do you have any suggestions/tips/ideas?  Of course we will appeal the decision.  We'll even change the diagnosis code, if needed.  What's most frustrating is insurance won't tell me what diagnosis codes they'll accept.  Apparently the diagnosis of a receptive and expressive speech delay isn't good enough to qualify for speech therapy.  If that's the case, what diagnosis is good enough?[/quote]

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