THE PRICE OF CARING FOR AN AUTISTIC LOVED ONE
Autism Has High Costs to U.S. Society
http://www.hsph.harvard.edu/news/press-releases/2006-releases/press04252006.html
http://www.nytimes.com/2010/01/23/health/23patient.html?pagewanted=all
http://www.hsph.harvard.edu/news/press-releases/2006-releases/press04252006.html
http://www.nytimes.com/2010/01/23/health/23patient.html?pagewanted=all
Taking care of a child with autism can be costly. According to the Havard School Of Public Health's 2006 Press Releases, it can cost well over $3 million to care for a person with autism over their lifetime. Caring for all children with autism in the U.S. for one year can cost an estimated $35 billion. There are two components of cost of caring for a child with autism, there direct and indirect costs. Direct cost can include but not limit to:
- Medical Costs, such as physicians, and outpatient services
- Prescription Medications
- Therapies
These direct cost can be up as high as almost $30,000 per year, per person, whereas the indirect cost, such as: special education, child care, camps can cost just under $40,000 per year, per person with mild forms of autism, and roughly $43,000 per year, per person with severe forms of autism. The cost of caring for children with autism can also leave the burden on parents, as autism may cause productivity loss. This can result in estimated costs for autistic individuals and their parents can range from $39,000 to $130,000 per year, per person.
Although health insurance is available for those with children on the autism spectrum, many insurance companies do not cover autism treatments, and many parents are stuck paying out of pocket for these expenses. Even those that do cover autism treatment expenses, the coverage is severely limited, with little government and private financial assistance available. Even with coverage for autism through health insurance, parents are struggling with the out of pocket expenses that are not covered. Financial support may be scarce and hard to obtain, there are autism information and advocacy groups, like Autism Speaks, that routinely help navigate through these financial burdens. Some families, especially poor families, have financial troubles due to their child(ren)'s autism, due to the outstandingly piling medical bills for treatment not covered by insurance.
HERE IS THE 3-STEP ROAD MAP PARENTS CAN USE TO GET STARTED:
-CHECK YOUR INSURANCE AND COVERAGE!!!!!!!!!!
- Coverage for autism treatment is still far from common, but is improving. Many large employers offer policies that do cover autism treatment. There are 29 States in the U.S. that mandated health insurance companies to provide coverage for the treatment of autism. They are Arizona, Arkansas, California, Colorado, Connecticut, Florida, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, Pennsylvania, Rhode Island, South Carolina, Texas, Vermont, Virginia, West Virginia and Wisconsin.
During the 2007-2008 legislative session, nine states passed legislation related to autism and insurance coverage. Arizona, Florida, Illinois, Louisiana, Pennsylvania, South Carolina and Texas enacted legislation specifically requiring coverage for autism. In addition, Massachusetts enacted legislation in 2008 to specify that autism shall be covered under mental health parity laws on a nondiscriminatory basis. Connecticut enacted legislation in 2008 that requires insurers to provide coverage for physical, speech and occupational therapy services for the treatment of autism spectrum disorders to the extent that such services are a covered benefit for other diseases and conditions under such policy. A summary of this legislation is included in the two tables below.
In 2009, Colorado, Connecticut, Montana, Nevada, New Jersey, New Mexico and Wisconsin enacted legislation requiring insurance coverage for autism. Illinois enacted legislation requiring insurance coverage for habilitative services for children with a congenital or genetic disorder, including autism.
In 2010, Iowa, Kansas, Kentucky, Maine, Massachusetts, Missouri, New Hampshire and Vermont enacted legislation requiring insurance coverage for autism. In addition, in April 2010, Oklahoma enacted legislation to specify that health insurance policies must provide the same coverage and benefits to children who have been diagnosed with autism as children who have not been diagnosed with the disorder.
In 2011, Arkansas, California, New York, Rhode Island, Virginia, and West Virginia enacted legislation requiring insurance coverage for autism spectrum disorders.
- If you do have coverage, watch for limitations. Treatment for autism is so individualized, there are few uniform standard and protocols for insurance companies to follow. Many parents have argued that a certain therapy or treatment is necessary.
- Check Any Caps On Treatment:
What caps that may look generous, for example $36,000, can be used fairly quickly. There also may be limitations on how many sessions of a particular type of therapy will be paid per year.
- Coordinate coverage with school services
- Coordinate your coverage with the services given to your autistic child(ren) from your child(ren)'s school. If an occupational therapist sees your child regularly in school, you might want to save your health insurance dollars for therapies that are not received from the school, such as social interaction therapy.
- ALSO, be aggressive about coverage for other medical conditions that your autistic child(ren) may have. For example: Gastrointestinal problems, or Seizures, which are common in many autistic children.
LOOK INTO GETTING A MEDICAID WAIVER!!!!!!!!!!
In many states, Medicaid coverage is available for children with autism, regardless of income - only regarding the child(ren)'s diagnosis. This is usually reserved for moderate to severe forms of autism, but may be worth to consider it.
To see if your child is eligible for the Medicaid Waiver, go to the Centers for Medicare and Medicaid Services Web site and click on your state. Waiting lists are extremely long, so you may want to apply for it as soon as possible. DO NOT BE DISCOURAGED.
GO LOCAL!!!!!!
There are many autism advocacy organizations, like Autism Speaks, that are affiliated with local chapters throughout the country. Most cities, towns, counties, and states will provide local autism resources in your area. They will also notify you of latest research on treatments for autism, and will also help with what dentists, optometrists, and even barbers that are good with autistic children.
- Medical Costs, such as physicians, and outpatient services
- Prescription Medications
- Therapies
These direct cost can be up as high as almost $30,000 per year, per person, whereas the indirect cost, such as: special education, child care, camps can cost just under $40,000 per year, per person with mild forms of autism, and roughly $43,000 per year, per person with severe forms of autism. The cost of caring for children with autism can also leave the burden on parents, as autism may cause productivity loss. This can result in estimated costs for autistic individuals and their parents can range from $39,000 to $130,000 per year, per person.
Although health insurance is available for those with children on the autism spectrum, many insurance companies do not cover autism treatments, and many parents are stuck paying out of pocket for these expenses. Even those that do cover autism treatment expenses, the coverage is severely limited, with little government and private financial assistance available. Even with coverage for autism through health insurance, parents are struggling with the out of pocket expenses that are not covered. Financial support may be scarce and hard to obtain, there are autism information and advocacy groups, like Autism Speaks, that routinely help navigate through these financial burdens. Some families, especially poor families, have financial troubles due to their child(ren)'s autism, due to the outstandingly piling medical bills for treatment not covered by insurance.
HERE IS THE 3-STEP ROAD MAP PARENTS CAN USE TO GET STARTED:
-CHECK YOUR INSURANCE AND COVERAGE!!!!!!!!!!
- Coverage for autism treatment is still far from common, but is improving. Many large employers offer policies that do cover autism treatment. There are 29 States in the U.S. that mandated health insurance companies to provide coverage for the treatment of autism. They are Arizona, Arkansas, California, Colorado, Connecticut, Florida, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, Pennsylvania, Rhode Island, South Carolina, Texas, Vermont, Virginia, West Virginia and Wisconsin.
During the 2007-2008 legislative session, nine states passed legislation related to autism and insurance coverage. Arizona, Florida, Illinois, Louisiana, Pennsylvania, South Carolina and Texas enacted legislation specifically requiring coverage for autism. In addition, Massachusetts enacted legislation in 2008 to specify that autism shall be covered under mental health parity laws on a nondiscriminatory basis. Connecticut enacted legislation in 2008 that requires insurers to provide coverage for physical, speech and occupational therapy services for the treatment of autism spectrum disorders to the extent that such services are a covered benefit for other diseases and conditions under such policy. A summary of this legislation is included in the two tables below.
In 2009, Colorado, Connecticut, Montana, Nevada, New Jersey, New Mexico and Wisconsin enacted legislation requiring insurance coverage for autism. Illinois enacted legislation requiring insurance coverage for habilitative services for children with a congenital or genetic disorder, including autism.
In 2010, Iowa, Kansas, Kentucky, Maine, Massachusetts, Missouri, New Hampshire and Vermont enacted legislation requiring insurance coverage for autism. In addition, in April 2010, Oklahoma enacted legislation to specify that health insurance policies must provide the same coverage and benefits to children who have been diagnosed with autism as children who have not been diagnosed with the disorder.
In 2011, Arkansas, California, New York, Rhode Island, Virginia, and West Virginia enacted legislation requiring insurance coverage for autism spectrum disorders.
- If you do have coverage, watch for limitations. Treatment for autism is so individualized, there are few uniform standard and protocols for insurance companies to follow. Many parents have argued that a certain therapy or treatment is necessary.
- Check Any Caps On Treatment:
What caps that may look generous, for example $36,000, can be used fairly quickly. There also may be limitations on how many sessions of a particular type of therapy will be paid per year.
- Coordinate coverage with school services
- Coordinate your coverage with the services given to your autistic child(ren) from your child(ren)'s school. If an occupational therapist sees your child regularly in school, you might want to save your health insurance dollars for therapies that are not received from the school, such as social interaction therapy.
- ALSO, be aggressive about coverage for other medical conditions that your autistic child(ren) may have. For example: Gastrointestinal problems, or Seizures, which are common in many autistic children.
LOOK INTO GETTING A MEDICAID WAIVER!!!!!!!!!!
In many states, Medicaid coverage is available for children with autism, regardless of income - only regarding the child(ren)'s diagnosis. This is usually reserved for moderate to severe forms of autism, but may be worth to consider it.
To see if your child is eligible for the Medicaid Waiver, go to the Centers for Medicare and Medicaid Services Web site and click on your state. Waiting lists are extremely long, so you may want to apply for it as soon as possible. DO NOT BE DISCOURAGED.
GO LOCAL!!!!!!
There are many autism advocacy organizations, like Autism Speaks, that are affiliated with local chapters throughout the country. Most cities, towns, counties, and states will provide local autism resources in your area. They will also notify you of latest research on treatments for autism, and will also help with what dentists, optometrists, and even barbers that are good with autistic children.