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[quote=Anonymous][quote=Anonymous]OP Here - open season is soon and I will change insurance policies.  I'm thinking the Federal BCBS will be better, but I still need to research it.  The immediate issue is the $$$ bills that I unexpectantly received in the mail last month.  Insurance was paying for the service, and now they're not.  I need to appeal those bills.

As for Habilitative Therapy, according to my plan, it's covered for children under the age of 19.  I'm just at a loss over how this happened.  Especially since I confirmed speech therapy/early intervention services were covered before we started.

I appreciate everyone's suggestions and feedback - this is new territory for me.  Obviously I want the best for my child, and I'll pay what I have to pay, but DC has a life-long condition.  Having insurance cover these therapies is financially important.  [/quote]

The life-long condition part could be part of the issue. They may be saying that (in their opinion) the prospect for your child ever gaining functional speech is slim. (aka experimental).

Do you have a neurologist or developmental pediatrician who would put in writing that speech therapy is a medical necessity for your child? Since you're in an HMO for the purposes of the past bills it would probably help if that doctor were in the HMO network.

Good luck. [/quote]

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