I Hate Insurance Companies

I.

Hate.

Insurance.

Companies.

There, I said it. Now tell me any of you out there disagree with that comment, I would find it hard to believe. Recently my husband's employer decided to switch insurance companies. This meant I had to find a new pediatrician for Thomas and had to wait and worry if all of his specialists would be covered. Luckily they almost all are. All but one to be exact.

Unfortunately that one is the one I most wanted to keep. He is Thomas' physiatrist, in charge of managing his cerebral palsy. He is the second one we have gone to see and the only one we ever want to see again. This guy can deliver a dozen injections of botox in Thomas' legs without Thomas even shedding a single tear! He agrees with me, so far, on everything. We have the same views on treatment and on how I should let Thomas live his life.

I cannot give him up. I won't. I'll take out a loan, remortgage my house if I have to. In a world of so-so doctors who may or may not actually know what they are doing, this one is genuinely knowledgeable and up-to-date on all the latest treatment options. He travels across the globe to gain this knowledge. And now my insurance company won't cover him.

I. Hate. Insurance. Companies.

There is hope. I can possibly keep him under a "continuity of care" clause in which the insurance company will allow Thomas to continue seeing this doctor based on their history together. I'm nervous because it has been only 13 months since we found him, I don't know if that is long enough. Another loophole could be if there are no other physiatrists near enough who will accept pediatric cases. If I remember correctly there aren't any others around, except our old one who, when giving Thomas his botox injections upon which Thomas would cry his little heart out, would say "stop being a baby!" Ummm, hello?!? HE IS A BABY!

So, those of you who pray, those of you who meditate, those of you who sacrifice chickens or other livestock, please do what you must so we can keep our beloved Dr. Dabrowski!

Just Our Luck

A few months ago I tried to get Thomas into an intensive therapy program called Europeds. There are only 2 or 3 centers in the entire United States and we just happen to live less than two hours from one of them. At the time the waiting list was extremely long, but we were put on it and patiently waited to get the call.

Meanwhile our new physiatrist got on the ball. He gave Thomas botox injections in his legs, has him being casted and going through physical and occupational therapy, and wrote a prescription for a new set of AFO's (leg braces).

Our insurance company will only cover 60 consecutive days of therapy per YEAR. So however many visits we can fit in a year is all we get. They consider the casting as therapy so that takes away from his 60 consecutive days.

Well, today I got the call from Europeds, they have reached our name on the waiting list. We have just one more full week of therapy available through our insurance though. I am beyond bummed about this. I have heard such great things about Europeds and seen some amazing videos on their website. It makes me so mad that they finally have room for us and we don't have the means to cover the expense.

They have put us back on the list for the first of the year, when our insurance replenishes the 60 days. I am going to make sure I have all my ducks in a row for when the time comes so I don't have to fight with my pediatrician over the referral for this therapy. So I'm keeping my fingers crossed that he can get in in January 2008.