Finding Insurance Coverage for Families with Autism

Click HERE for a link to the Autism Speaks Walk website.

The Autism Speaks walk is Sunday.

One of the organizations goals is help pass legislation for insurance companies to cover autism therapy, so families don't have to bear the financial burden on their own.

Jake Martinez enjoys recess like any other eight-year-old.

But to help him function and interact like any other kid, he needs expensive speech and occupational therapy.

Jake's mom Cathy Martinez says, "Jake has some major sensory issues, so haircuts and brushing teeth are incredibly difficult for him. We've worked on desensitization for about four years on both of those items. He's still not doing those independently, but it's getting better."

It's necessary therapy that doesn't come cheap.

Cathy says, "We can't afford the additional 32 visits that our insurance doesn't cover. And at roughly 160 dollars per and combined for the 32 occupational and the 32 speech, that's 64 visits at 160 dollars an hour that we would be responsible for out of pocket."

Last year the Martinez's filed bankruptcy. It's a financial burden that many families with autism face.

Cathy tells 10/11, "We were forced to make choices that I don't think families should have to make, between having a college or tuition fund set-up for our other three children, or to fund Jake's therapy. Or to file bankruptcy and fund Jake's therapy or have a 401k, those aren't decisions people should have to make in order to help their child."

Vicki Depenbush is the mother of a child with autism and is with the Autism Family Network. She says, "The stress is overwhelming. I know for our group, the rate of divorce for families with autism is incredibly high. The emotional burden, because it's 24/7. If you have a child who elopes--just takes off at times and they're non-verbal, 'What do you do?'"

In the autism spectrum, Jake falls on the moderate to severe side. That's why his parents chose to be aggressive with therapy.

Cathy, "It's the very frusturating part with autism, is everyone pushes for early diagnosis, but than there's no insurance coverage in the State of Nebraska for autism therapy, so parents find out earlier that their children have autism, but are left with no resources to help their child."

In the Nebraska Legislature, senators have previously introduced bills to have medicaid and medicare cover the autism therapy costs. But those didn't pass. Now Senator Amanda McGill is working on legislation that would create a special field of so insurance companies will cover the therapy.

Amanda McGill, "I've introduced legislation for what is called Applied Behavorial Analysts. They're specialists in autism that help a child develop their speaking skills and communication skills and right now insurance isn't covering that kind of therapy--it needs to be its own specialty. So we're trying to find ways that families can get those additional skills and therapies."

According to the Autism Speaks website, 23 states including Iowa, Kansas, Missouri and Colorado have passed autism reform laws. But so far, Nebraska hasn't. Families with autism hope that will change, but they know getting it covered won't be an easy task

Vicki Depenbusch, "It's going to be a long term struggle. With the help of Autism Speaks and their legislative department, I think we have a really good chance, but I do think it's going to be a long term stuggle."

Because in the end, it's about kids like Jake who can't talk, that they're fighting for.

To learn more about the Autism Speaks walk on Sunday, October 9th, click on the link to the left.


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