There IS a Light at the End of the Tunnel

I spoke with the nurse at Daniel's developmental pediatrician's office today, and she confirmed to me that Daniel does, indeed, have an autism spectrum disorder. She faxed the information to Frank at work this afternoon; he will be forwarding that information, as well as a copy of the Illinois autism mandate, to Aetna on Monday morning.

I called Aetna's customer service number this week to find out which diagnosis codes were used in the billing for our visits with the Dev. Ped., and their representative told me what they were. She also confirmed to me that they were appropriate codes for this autism spectrum disorder diagnosis. Daniel started seeing this doctor on Oct. 30, 2008 - his 5th birthday. It was after the new legislation went into effect for us (August 2009) that Aetna denied our request for coverage for therapy. The reason we were given - we do not have coverage for this type of services. Really?!?!? According to Illinois law, we most certainly do. I'm interested to see what the outcome of our appeal will be. We do have an attorney, and he will call Aetna if necessary.

The funny thing is that I've had numerous therapists and doctors tell me not to give up because that's what Aetna wants me to do. They call it the insurance game, and that's what I was calling it before any of them ever mentioned that phrase to me. Only 2 people have tried to talk me out of continuing therapy, but I just knew that God was going to work this whole thing out somehow.
I truly believe that God directs every step we take in our lives, and it was by no accident that we decided to take Daniel to a developmental pediatrician and that we found out about the autism mandate. I posted a couple of Facebook notes about this, and I tagged a friend in the note who is an attorney who is familiar with this type of thing. She was not in my mind immediately as I was tagging people, but something kept telling me I should tag her in the note. I listened to that still, small voice, and it proved invaluable. She posted a comment on locating advocacy groups for help, and I did just that. I googled advocacy groups in NW Indiana, and I called 5 of them.

Two people called me back - one who really didn't help me and another one who had more information than I could have ever hoped to find. She's the one who pointed me in the direction of Illinois' law regarding insurance coverage for children with autism spectrum disorders. She also told me about the new legislation Gov. Quinn signed regarding coverage for children with developmental disabilities. That law takes effect on January 1, 2010, and I'm telling everyone I know about it. The more we moms of kids with special needs can help each other, the better.

It's very comforting to know that an insurance company like Aetna would seek to deny a child the only treatment for his medical condition(s) that would help him overcome it, but God will not allow such a thing to happen. One of the songs we sing at home and in church talks about how He's the Defender of the weak, and I can definitely see that in Daniel's life. Because of his sensory problems, virtually everything for him is a struggle - eating, brushing his teeth, writing his name, etc. Yet, God has brought him this far, and He's not about to let an insurance company stop what He has started in Daniel's life.

God definitely has a purpose and a plan for Daniel's life. He is amazingly sweet and kind-hearted. I truly believe that he's come such a long way in the past 3 years because we have not only made sure he has the medical care he needs, but we believe that God has much more planned for him than we can ever imagine.

"For I know the plans I have for you," declares the Lord, "plans to prosper you and not to harm you, plans to give you a hope and a future." Jeremiah 29:11