I have been a teacher for 11 years now and have enjoyed great coverage for DS for his vision checks, his SLP and OT.
We just got a district email saying how we could join this group and save significantly. FTR, we get about $800/month for a plan of our choice and then pay out of pocket any difference. Two years ago my plan was an additional $140 a month and it jumped to $280 last year. BUT, my plan is amazing. Unlimited PT and 45 speech visits. Now the
best plans on these new companies cap at 60 combined of all therapies.
I know many of you guys are used to these lower caps, but I am so upset because I have enjoyed not having to limit how much my son gets. I just pay the co-pays everytime. I hope I do not sound like a whiner (please do not flame me I know many of you can relate to spending a lot of money on your child's care), but I think these so-called lower rates are probably due to cutting some of these perks that teachers had bargained for in the past.
No point to the post other than needing a place to get it off my chest. The second crappy thing is that my OT does not like to work with Group Health and does not work with the other company they are offering. Any of you guys heard of UMP? Anyway, I am afraid to even begin asking DS's other health care providers if they take these insurance companies. They are offering an informational school district meeting to give the details of the new companies in July, but I think its just a formality to a decision they are already making
I seriously want to throat punch the person that thought this was a good idea. I get it though, my situation is very different than most people and they are not worrying about if their plan covers speech therapy visits or not. Everyone just wants to pay less. {SAD FACE}
Re: Insurance vent :(
Luckily, the state I live in passed a new law and enough people fought it that things have changed again.
Just wanted to say I am sorry. I know how much it sucks.
For us, without a "covered" DX (ASD, etc.), nothing is covered. We knew DS needed therapy though, so we've been paying out of pocket...we've dropped a pretty penny in the last 2 years and nothing will be reimbursed.
I know down the road, the district is going to be involved. Since he has a summer birthday, our plan is to wait until age 6 anyway or he would be a very fresh age 5. Truth be told, I am not sure if he would be mainstreamed by 6 anyway. We may be looking at an ASD classroom or something similar. His SLP believes that he may be ready to be in kinder by age 6, with the proper supports. I guess no one will really know what that will look like since this is not for two more years.
He had his 4 year old well check visit and his regular pedi thinks this is a good plan for now. He knows a dev pedi that can look at him about 6 months before kinder. He told me not to worry I am getting DS great services right now. He is the type of doctor that waits to see how things present themselves and is not in a rush to get him DX just yet. I know this can be a good or bad thing.
Now if my insurance changes we may have to have a dx in order to get covered, again, something I won't know for quite some time. I wrote an email to my union rep of the district and she said as a bargaining unit, we will be voting on this in September/October and the actual coverage would begin in January. Sucks that i won't know for a while. On a side note, I talked to my SLP today and she groaned at the possibility of me switching to Group Health. She also said they are not easy to work with at all.
To everyone else responding to my whines, thanks.
I hate to say it, it's the healthcare law changes that are the driver in a lot of these changes you're experiencing. Ours went up over $100/mo on the premiums and the services we now have covered are peanuts compared to what we used to have. But rest assured, our deductible tripled..
We used to have just under a "Cadillac" plan for insurance but since the law changes have taken effect, we can't even purchase that plan even on our own without the employer which covered FAR FAR more than what our current, and far more expensive plan does. I used to have unlimited visits to the Chiro and now they cap it at 10 per year. I used to be able to go to any doctor/specialist for a $40 copay, now they bill but we never know how much it's going to be and usually it's $100+ which adds up quickly when you've got a kiddo that needs more visits than the average well baby/child. Routine foot care (DH had a corn cut down at the doc's office) - not covered - to the tune of $250 for what amounted to a <3minute procedure - on top of the reason for the office visit which was another $120... I honestly have sat back many times and wondered if we showed up to the doc and paid out of pocket if it'd be cheaper than going through insurance... really...