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January 31, 2009

“You’re Doing Fine, Oklahoma!”

My husband and I have Blue Cross Blue Shield of Oklahoma as our health insurance provider.  Now, some of you may have groaned when you read that since BCBS isn’t known, by some, as being the best provider.

Then again, some of you may have cheered because you absolutely love BCBS, and you wouldn’t leave your health benefits in some other provider’s hands, so to speak.

If you haven’t been living under a rock, you’ve probably heard about parents demanding autism benefits from health insurance companies.  Just Google “autism health insurance”, and you’ll get 1.5M pages to check out.

Have fun with that!

Now, if you have been living under a rock, and I suggest getting some therapy for that little problem, you may not know what “all the fuss is about”.

Again… not every child on the spectrum, like my son, qualifies for medicaid because, according to some parents, their children are denied for “not being autistic enough”.

So, the “fuss” is this… in order for our children to thrive and succeed in life, they need speech, occupational, and even physical therapy to help them along.  And these required therapies cost big dollars.  Upwards of $1,000 a week for some families.

For some, these therapies won’t be a lifelong requirement; for others, they will.

Can you imagine shelling out $52,000 a year for essential medical treatment? Some folks don’t even make that in a year!

Imagine those families who are already financially strapped… y’know those folks who are barely making ends meet, yet, they’re paying exuberant out-of-pocket expenses because insurance companies won’t cover behavior therapy.

In the past two years, 6 states have passed laws requiring this coverage, and in some cases, costing as much as $50,000 a year per child.

Welcome aboard… Texas, Pennsylvania, Arizona, Florida, South Carolina, and Louisiana.

Now, a lot of people are against these mandates because they feel that they’ll be forced to pay higher premiums because of these laws.

Funny, how these same folks don’t say boo when their tax dollars are used to ensure that criminals get three squares a day, rehabilitation and therapy, and a solid education.

Anyhoo, let’s get back to Oklahoma.

Last year, Nick’s Law (OK’s autism bill which would provide insurance coverage for the early diagnosis testing of autism and medications until the child reaches age 21.) was blocked by the House’s committee chairman who refused to give it a hearing.

While the House is over there twittling their thumbs, we forge ahead.

Here’s some good news…

Blue Cross and Blue Shield of Oklahoma announced in December that autism spectrum benefits will be provided in 2010.

A BCBS overview provided to The Edmond Sun by Cooksey’s office states the autism benefit rate increase will be 0.22 percent to the entire block of business, or a 2.1 percent increase in the child rate.
BCBS benefits beginning at birth would end on a child’s sixth birthday. The annual maximum benefit is $25,000 and the lifetime maximum limit is $75,000. This benefit includes evaluation and management procedures, speech therapy, physical therapy and occupational therapy.

Source: Nick’s Law and Autism Legislation in Oklahoma

Wow!  Way to go, BCBS!

Should conventional health insurers provide coverage for all, or should we hold firm to the old way of doing things by continuing to deny people in need?

What are your thoughts on the matter?  Oh, and why do people keep running over a string a dozen times with their vacuum cleaners… only to reach down, pick it up, examine it, then put it down to give the vacuum one more chance?

**While you chew on that for a spell… here’s some tune-ich to keep you company. ;-)**


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