Working moms of ASD's WWYD & MA Tefra Q
MirandaHobbes
member
DS is 3 and in the public ASD preschool 10 hours a week. The rest of the time he's in a typical daycare. Our dev. pedi wants him to have at least 15 additional hours of therapy a week. Our insurance covers one hour of ST and one hour of OT a week- that's it. Even if we could afford 13 hours of therapy OOP (we can't), I have no idea how we would get him to all these appointments. Because of our jobs, he has to be at one spot for the duration, or be bussed by the public school. So I want to do more- I just have to figure out how.
We have a couple options- and I'm interested to hear what your family does. Option 1 is pretty good- we'd have to pull him from his daycare that he loves, but move him to a daycare for special needs kids (all types of special needs with some typical kids as well). At this facility he would also be able to receive ST and OT billed through insurance. I think this is where we're headed, even though I'm remiss to tear him from his daycare that we love so much. The downside to this option- he still won't be receiving ASD specific behavioral therapy since our insurance doesn't cover it.
Our other option is MA TEFRA. I've done all the paperwork and found out that our parent fee would be about the same as what we pay monthly in daycare costs- so we can only afford one or the other. If we had MA, is there a way to structure his day so that he's in covered therapy all day? Or does TEFRA cover respite care, like daycare? I know there are autism day programs in our city- and there are also autism preschools that are just half day- I don't know which is preferable. Also, I don't even know if MA TEFRA is available to DS- are you considered disabled "enough" if you have a medical diagnosis- or does this vary state to state? I've read all the legal jargon but it is vague and says it's case-by-case, and that the individual needs to be "severely" disabled.
Sorry for all info dump- I am meeting with county workers, the autism facility, and our dev. pedi again next week so I'm just trying to get my thoughts in order and come in prepared with good questions. Any advice appreciated- thanks!
Re: Working moms of ASD's WWYD & MA Tefra Q
Just looked up your state laws, looks like they are working on autism reform in your state. Keeping fingers crossed for you.
I don't know a thing about TEFRA, but what I just looked up on the internet. Any child with a ASD dx should be able to acquire medicaid disability, but again, I am not an expert on that. I know that there are waivers you can get as well, that could cover some of that extra cost for "respite," which I have heard can be ABA based. My ds is on Indiana medicaid, but we have yet to use it because it is income based and with a two income family, our out of pocket before medicaid will kick in per month is outrageous.
I am a working mom. My ds gets all his therapies privately, we have a private policy for him and are working out the kinks and should be able to get him covered on my employer one any day now. But, that is because we have laws mandating coverage.
Schedule wise, most of his ABA instructors actually come to his current mainstream pre-school. He does get a few hours outside of pre-school, and my dh, family and myself all pitch in during the week with that. My dh is off on Friday's, so that helps with transportation that day. I also do some hours with him on the weekend myself. That is how we get the extra hours in.
Every child is different and every program may not be suited for every ASD child. You know your child best and you will make the best decision. Good luck.