October 16, 2009

Red Tape and Oh the Paperwork!

We're working with our doctor and insurance company to get a waiver of authorization so that Chase can get a reflux medicine actually made for babies that will work for him. The process of grinding up adult tablets and trying to get him to swallow the awful-tasting ground powder is as difficult as you would assume. We would like him to take Prevacid, but the insurance company needs to approve this. So that's one of the things we're working on. In the meantime, we'll continue with the over the counter Prilosec.

As we add therapies and work to get our insurance company to pay for what Chase needs, I've started the application process for Georgia's Deeming Waiver (formerly known as the Katie Beckett waiver). Since our family does not financially qualify for medicaid, we must pay for what our insurance company does not cover. At the start of 2010, Chase's deductibles will rise. Therapies, especially speech therapy, will be scrutinized and not all of it will be covered by the insurance. To compensate, the state of Georgia provides a waiver so that people who have lots of medical needs (like Chase) can get supplemental medical insurance through medicaid.

It is hard to be approved for the deeming waiver, and there is a mountain of paperwork to apply. We must get paperwork from two doctors, three specialists, three therapists, two service coordinators, and a representative from medicaid. We may even have to get Chase a psychological evaluation (which I really do find humorous as he is only seven months!). So the ball is rolling, and hopefully we can get all this accomplished by the end of the year.

Whether we will be accepted for this waiver is up to the Dept. of Family Services (and God). Many kids in Chase's situation are denied. In the grand scheme of things, Chase is super healthy and hardly has any issues at all, so he may not be approved. If so, we will reapply when Chase is three, when it will be more obvious that he has developmental delays, etc. In the meantime, we really have been blessed to have good insurance and a plan that has paid for most everything this first year.

3 comments:

  1. Wow the state of GA makes it hard! PA medicaid automatically covers for kid's with DS. But we still had to go through the process of proving he had DS. Anyways, hope you can get Prevacid covered and hope that Chase will qualify for services!!

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  2. Oh and btw- Chase looks adorable sitting like a big boy!

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  3. Discovered your blog through Adgitize. It's great. I've given you an award over at myqualityday.blogspot.com

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