Ok, Ok, I know that could sound bad, but it’s not what you might think. Any type of progress in terms of insurance coverage is a sign of hope for me. Like yesterday, I went to pick up my birth control and I whipped out my debit card to pay the copay- the pharmacy technician told me to have a good day after I signed the HIPAA thing. I said, I’m sorry, but I haven’t paid yet. Her response- it’s free.
I’m out of touch apparently and didn’t know this had actually gone through. While I disagree with quite a few aspects of obamacare, this is a good call. I know that some feel like it’s the government’s way of trying to control population growth, but until they are forcing birth control down your throat or holding you down to make you take Depo shots, that’s simply not true. Unwanted pregnancy prevention is a good thing for both mom and potential baby. As a nurse who has worked in the inner city, trust me when I say this. It is not an opinion, it is fact.
So let’s take a little journey through the history of contraception coverage. When I was a teenager, my OB/GYN wanted to put me on birth control pills due to some issues I was having; she told me at the time that she had to label it as such diagnosis-wise for insurance purposes, otherwise they would not cover it. In other words, there was no coverage for birth control when used as birth control, only when used to regulate a cycle. When I was in my twenties, I could go to the student health center and purchase it for a cheaper price, in my late twenties, when the copays were still very high for birth control, if there was coverage at all, I went to Planned Parenthood, because I would rather give my money to a cause that is helping young girls prevent pregnancy than to the insurance company. I know that many individuals who are “pro-life” would disagree with this decision, but once again, it is the practical, experienced nurse side of me that sees the necessity of this organization. And for the past 10 years or so, birth control has had the same copay as any other prescription, which frankly was fine with me.
So now it’s FREE
The parallel to autism is fairly obvious. Right now, almost no medical intervention is covered for the diagnosis of autism, right? It’s not acknowledged by the government as the public health issue that it has come to be. It’s not recognized for the medical problem that it is- it’s still considered a behavioral issue only. And thus insurance coverage for medical intervention is not mandated, as it should be. For interventions such as occupational therapy, speech therapy, physical therapy, feeding therapy, etc., most professionals are careful to use a diagnosis of developmental delay, speech delay, dysphagia, etc. Because if the diagnosis of autism is used, it will not be covered. Even if these services are covered under developmental delay, the number of allotted sessions is often inadequate, as the coverage is not tailored to the needs of a person with autism. It is not being acknowledged that these are effective and medically necessary treatments for autism. My hope, and prayer is that autism coverage will follow a similar trajectory (more rapid preferably) and that in the future, when a parent faces a diagnosis of autism they will have the comfort of knowing they can obtain help for their child. Unfortunately, the issue is complex, and I fear that it will be a long road. Anyway, this instance does give me hope that the changes that are needed are possible.
Yes, we can only hope and pray that coverage will come soon. My son, Michael, is high functioning and we didn't need nearly the services as some other families. We were lucky. I can only imagine the expenses that families go through who have children in other parts of the spectrum.
ReplyDeleteHere is more of a parallel: autism services are underfunded and MY birth control wasn't covered until this year. I take Seasonique, which is over $200 for a 3 month supply. I need the more expensive product due to PMDD and how it impacts my mood. Combine this with having hfa/AS and you can see why it is essential. I used to get samples, but that ended this year, so I had to apply to the insurance gods to get covered-which included a note from my gynecologist. I also have the emotional and educational guidance of my (retired) nurse mother, who helped me navigate this process. Autism and birth-control seem to be more alike in struggle for me.
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