Friday, December 5, 2008

An update on the insurance madness

I spoke with a Cigna representative today. Their official stance is that Will's speech therapy is not covered because there is no underlying "medical condition" that necessitates the therapy. I explain to him that Will has been labeled as developmentally delayed since he was 19-months-old. Well, Cigna doesn't consider developmental delays medical conditions because, and I quote, "everyone develops differently." O-kay. So I explain that my 4-year-old is talking at or below the level of a 2-year-old. Nothing. I start asking what medical conditions would qualify Will for services and he pretty much refused to give me this information. He said a therapist or doctor would be able to tell me what underlying medical condition is causing Will's delays. This went on and on, back and forth for about 45 minutes. We agreed that I would send in Will's speech therapy evaluations that he's received over the past few years. We'll see what Cigna chooses to do with them. But I still think we're gearing up for a fight on this one. I'll keep you posted!

1 comment:

Anonymous said...

Unless the treatment is restorative in nature, it is not covered. Most insurance companies don't want to pay for services that are typically covered by state, county, or school services.

You might want to also call your county's early intervention program and have them come out and do an assessment. Depending on their funding, you might end up getting better service in your home.