
Christi - posted on 08/22/2010 ( 27 moms have responded )
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my son was diagnosed with mild autism or pdd two days ago and while it really shocked us, we are trying to get him all the help he needs. our insurance is self funding which means they don't have to cover his aba therapy. my son is enrolled in eci and a treamtent center i talked to today said that they have to cover his therapy. is that true?
my next question is how do i apply for medicaid, what will we have to pay for it, and what all will they cover for my son and how much will we need to pay for his therapy? we are literally barely scraping by and now since he is going to require therapy almost daily, i will not be going to work anytime soon. if we apply for medicaid, can we also receive social security diability checks or is medicaid all we can get and if he is on medicaid does that mean that he can no longer be on our insurance? i am really confused and need some answers fast so i know what course of action to take to ensure he gets the help he needs asap. he is 20 months and we live in dallas, texas if that helps any. thank you!!!
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Melissa - posted on 08/25/2010
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You also probably qualify for IHSS (In Home Supportive Services). This program will pay someone to help your child (and that person can be you). There are some hoops to jump through, but it is definitely something that will help, especially since you can not work because you have to take care of him. They also have a type of IHSS that is called protective supervision. Document everything that he does that places himself in danger. Make sure it's
clear that it's due to his disability, not a behavioral issue. They will make a big deal of not funding help for behavioral issues, just developmental ones.
You'll need to discuss things like firestarting, wandering off, self-harming behaviors, etc. Anything he would do that would hurt himself if he didn't have
direct supervision and how his need for supervision is much higher than normal for his age. The younger they are the more supervision would normally be given so the more documentation you can give the better.
Usually for protective supervision, the max hours they will approve is 195hrs at $9.30/hr (this info applies to CA...not sure if it applies to other states). Some people also get normal IHSS, and they will lower the protective hours, but the total hours will still add up to 195, so its the same. Some people have managed to get more hours, but I don't know how they did it.
We're in the process of applying to SSI and IHSS for our son, so all this info has come from friends who have gone through this.
Lisa - posted on 09/01/2010
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I have applied for SSD several times and was told we made too much money and we needed to wait till he is 17 yrs old to try again since he will probably never be able to work. They also told me that he is not elgible for Medicaid because we have private insurance (BC/BS). We have received NO help from the government. We were able to get him 6 months of early intervention due to finding out late of his autism. And he gets speech one on one twice a week plus everyday in group sessions for him being non-verbal. He also has sensory issues which if he smells something that makes him naucious he may throw up. The school wants to send him home everytime he throws up. I have given them a letter from the doctor stating about his sensory issues and they still call when he throws up.
He has outburts and tantrums at times if someone sets him off. The teacher complains. What does she think I'm going to do. I'm at work and I don't know what set him off. That is her job to figure that out. I think they have too many kids in these special needs classes to each aid. Our ratio is 4 or 5 to 1. That is unreal. Sorry I got up on my soapbox today.
JC does not get ABA therapy due to where I live there isn't anyone to teach him and we can't afford to pay someone anyways. Alabama is not a good state to get help. They do the minimum if you don't know your rights.
Sorry for the ranting. I hope everyone has a great day.