God is Faithful!

I got a letter from Aetna this morning, indicating that they were reversing their decision not to cover Daniel's therapy - but only for the month of July! Our initial letter of appeal requested that they reverse their decision not to cover therapy at all for all claims going forward. They must think we're not serious about making sure they follow Illinois law in providing coverage for his therapy.

As I sit here on hold, waiting for their senior representative to see if she can get a definitive answer about coverage for claims going forward from July on, I am planning to forward more information to the Illinois Insurance Commission. In our conference call with Aetna's representatives, we were told that their medical directors were board-certified family physicians. My letter says that a "medical director, board certified in Obstetrics and Gynecology," was involved in the review of our appeal. I find that quite interesting. When did an OB/GYN become a FAMILY doctor?!?!? What are their credentials in PEDIATRIC medicine? I'm sure that Daniel's doctors would be interested to know this. This is why I never believe anything anyone at Aetna tells me, and it is why I take very detailed notes every time I call them.

The findings of this, my latest call - therapy will be covered without limits under the directives of the Illinois Autism Mandate. I have documented the name of the person with whom I spoke, as well as everything she told me regarding how our claims will be handled. We'll see where we go from here. Hopefully, this is the end of the battle. Aetna stole an entire summer away from me and my children, and I will not allow them to steal any more of our precious time. If they do not cover therapy in accordance with the IL Autism mandate, I will seek legal counsel. Enough is enough. This never should have gotten so out of hand in the first place. This law was signed in November 2008, and it was effective for us when our policy renewed on July 1, 2009.

I find it interesting that, when I spoke to Aetna's representatives in June and told them he has an autism spectrum disorder, they told me they do not cover treatment for autism spectrum disorders. Yet, I'm sure they knew about the new law, and they were trying their best to get out of providing coverage, thinking we'd never find out about it. It was signed in November 2008, and it was effective December 18, 2008.

God holds Daniel's life in his hands, and He's not about to let an insurance company get away with such unethical practices. He has a purpose and a plan for Daniel's life, and He will make sure that no one, not even an insurance company, gets in His way.

"And we know that in all things God works for the good of those who love him, who have been called according to His purpose." Romans 8:28