This post is intended to educate other moms...please do not see this as us not being grateful. Our new ObamaCare plan with BCBS is no longer covering therapy (PT, OT, & Speech). After a denial (happens a good bit) we work to resubmit a claim & get approved. Today, I was informed that our old BCBS plan doesnt work like the new plan under ObamaCare, bc the federal government dictates the rules now. I was told resubmitting will probably not work. They said that under ObamaCare if it is documented in any way that there is a cognitive delay then therapy is denied. Aubrey is very smart & understands everything shes being told. Bc she cant function physically like other kids, naturally shes going to show signs of being behind in some areas. Regardless, it doesnt matter what a child understands, therapy for the physically disabled is crucial to their improvement & improvement of abilities they do have. Instead of fighting with the higher ups at BCBS, I now get to argue this case with lawmakers who know nothing about medicine. Yes, TEFFRA will cover therapies; however, there are limitations with TEFFRA. I obviously want to get Aubrey the max & we should be able to by having private insurance.
Posted on: Fri, 06 Jun 2014 13:53:17 +0000
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