I agree re: fight with PIE - we were able to get 2x/week PT for 7 mos, which made all of the difference for my DD. Basically, if they tell you that 1x is all they allow, ask to speak to supervisor, and then ask to speak to state supervisor if necessary. They will NOT want that. Tell them that whatever they need to "justify" it to the state you have and can give them. Ultimately, they should allow this but you will have to push. Do NOT be afraid to advocate for your child though.

OP - would it be possible to split the weekly hour session into 2 30 min sessions? When DD was in ST, her therapist recommended that and told our FX cty coordinator. All I had to do was sign a new authorization and we did that for 6 mths. I think the breaking it into 2 smaller sessions, helped DD pay attention more and make more progress.

I also had luck with pushing on the PIE program (we are in Arlington), although I hadn't expected to. They were not allowing us to pay privately for the same provider, and I didn't want my DC to have two speech therapists (this seemed unreasonable). So ultimately, with documentation from the dev. ped, they allowed 2x/week.

Also, call everyone that is in network for BCBS - you will probably find that all providers either have a waiting list or only see adults, etc. Then call BCBS and see what they can do. We were able to get our out of network provider paid for as in-network, since there were no available in-network providers. We now go to Georgetown for therapy - they are awesome, and take insurance.

One other thing to keep in mind as you weigh changing plans at open season - the reimbursement level from FEP BCBS Standard for speech therapy out of network is incredibly low. I think we were receiving $43 per session (which cost us $120), with a 75 visit max.

OP here. Thanks much for all your insights. I really appreciate it.

We really like our SLP through Alexandria PIES. Our coordinator told us that we could only do one session per week through PIES, but I’m going to ask if this can be upped if there is enough documentation and concern. Thanks to the PPs who mentioned that this approach worked for them; I’ll give it a try.

I’m going to research the practices PPs mentioned tomorrow. Again, thank you! Chatterbox in Alexandria and Exceptional Speech in Springfield (two groups that PPs mentioned that take insurance) would be the most convenient with regards to commuting, but I know there are other considerations too. I’m glad that the practice our developmental pediatrician recommended (CSLS in Arlington) is recommended by parents here too.

So yeah, I feel more optimistic now. I wasn’t having any luck when calling around to practices the past few days. I should have started here first rather than the insurance directory! Lesson learned…

Yeah, we definitely plan to switch from the basic PPO to the standard PPO in December. Basic has lower premiums but higher copays. Standard has higher premiums and lower copays. Up until this point, we calculated that it would be a wash for us. We have lots of doctor appointments, but they’ve all been preferred providers, so I’ve never had to worry about the out of network issue. But because the basic plan doesn’t cover anything for out of network specialists, we’ll need to switch to the standard plan in order to get a portion back. Arrrrggggg, insurance is such a headache!

I don’t think our parents can help, though I’m sure they would if they could. They have very modest incomes in the Midwest.

Anyway, thanks again for all your input!

My daughter has mixed expressive receptive language delay, and we've found the best speech therapy for her to be child led. Two suggestions...

Dr. Jim MacDonald's Communicating Partners: http://jamesdmacdonald.org/Articles/MacDonaldStart.html - there's a link On the left side of the page to the online discussion group, which is great.

Dr. Greenspan's Floortime: http://www.stanleygreenspan.com/for-parents/the-greenspan-floortime-approach-for-parents/. Right now it's $95 for 90 days of access to the training videos.

My dd is 10 now, and the best speech therapy for her has been with us. Your situation may be different, but I thought I'd throw this out there as food for thought.

OP when I was in this position with my child, I tried to learn how to do speech therapy -- as much as I could -- on my own. It wasn't ideal, but I simply couldn't afford to hire anyone.

http://teachmetotalk.com/2008/03/02/successful-strategies-for-working-with-toddlers-with-apraxia-and-other-speech-language-difficulties/

Georgetown Hosp takes carefirst/blue cross. Sheila skinner is awesome!

Our speech therapist doesnt take our insurance, but we file on our own for reimbursement, and we get back a big chunk of what we pay. Your insurance might be enough. Also doing twice a week (one you pay, one city pays) is really worth it even if you cant spring for 3 times a week.

Anonymous wrote:If Children's Speech and Language Services is close for you, and they seem to provide what your child needs, I would go ahead and schedule an evaluation with them and see what they say. Maybe they'll think DS needs 2x/week therapy or maybe they won't. We go to Children's Speech and Language Services in Springfield--they are truly excellent. DS started at 19 months and has motor speech planning issues. He has always gone only 1x/week--even when I asked at the beginning if he should come 2x/week. And, even if they say that 2x/week services would be best, tell them that you can afford and will start with 1 session per week for now. The specialists we have dealt with have always given their opinion about what would be best for DS (OT, ST, etc), but have also always understood that each family's resources aren't unlimited. You do the best you can/

Forgot to mention that I'll second the PP's recommendation of looking at Exceptional Children's Center. OP, I think we have the same insurance you do (FEP BCBS Basic), and they accept our insurance for OT--we pay only a $25 copay. I can't speak to their SLPs because we go to CSLS as noted above.

Anonymous wrote:OP here. We're in Alexandria city so have EI through Alexandria PIES. From what I gather, MOCO and Fairfax County are able to offer more for EI, but no need to go into that.

We have FEP Blue (Care First) basic PPO insurance. It actually covers 52 ST, OT, PT or a combo thereof a year. But we can't find anyone who will take it! We did check out Children's Speech & Language, but they don't take our insurance. I've heard and read good things about the practice though; we were actually referred to them by our developmental pediatrician. We may end up going there in the end even though it will all be out of pocket.

If you pay OOP, can you submit for reimbursement? Our crap insurance doesn't have any coverage for speech, but that's what we do for any other un-covered provider. While you'd have to shell out up front, if you found a no/low interest credit card to put the charges on, you'll still have to pay some yourself, but a lot less than footing the full payment.

Our 2yo child also has an expressive delay, and even increasing from once a week to 2x a week has proved to be really beneficial - so maybe once a week with EI and once a week private, if you can manage it.

The costs are definitely prohibitive. We can swing it, but not easily. I think you do what you can, evaluating as you go. Our pediatrician suggested that speech was something where we want to do as much as possible, and that's what we've done. Would adding an additional session a week help even more? Maybe. But we are doing what we can.

I second the UMD rec and encourage you to look around to graduate speech and hearing science depts to see if any in VA offer sessions. I'm pretty sure that GW does for a very modest rate to train grad students.

If Children's Speech and Language Services is close for you, and they seem to provide what your child needs, I would go ahead and schedule an evaluation with them and see what they say. Maybe they'll think DS needs 2x/week therapy or maybe they won't. We go to Children's Speech and Language Services in Springfield--they are truly excellent. DS started at 19 months and has motor speech planning issues. He has always gone only 1x/week--even when I asked at the beginning if he should come 2x/week. And, even if they say that 2x/week services would be best, tell them that you can afford and will start with 1 session per week for now. The specialists we have dealt with have always given their opinion about what would be best for DS (OT, ST, etc), but have also always understood that each family's resources aren't unlimited. You do the best you can/

18:00 here. Just reread your post about being in Alexandria City - nix the idea about FCPS preschool! Sorry!

Have you tried Exceptional Children's Center in Springfield? We have Carefirst BCBS (also a PPO, but not the fed) and they take our insurance. Also, is there any chance that your child would qualify for one of the FCPS preschool programs?

Fleming Therapy-I think they have several office in northern va. I know one is in Centreville. They take a lot of insurance in-network for speech. If you are paying cash, I think it is 60.00 for 40 minutes.

I have two SN kids and speech therapy is the only intervention I am 100% sure hugely benefited both of them.