Saturday, January 21, 2012

a head ripped off (and some pictures)...

The last few days have been depressing. We're facing some challenges with insurance coverage related to Isaac's therapies. At this point, it looks like it will all work out and that we will receive money from a fund at the hospital to pay for his therapy. But that doesn't change the fact that there is an overwhelming movement of discrimination against children with special needs. I talked with Isaac's case manager who helped us during his first surgery, and she asked, "Is Isaac walking, talking, and feeding himself like a typically developing twenty-one month old?" Obviously, the answer is no, because he has a genetic condition, and his brain and body don't work that way at the moment. Guess what? The insurance doesn't care what condition he has because anyone with mental retardation or any need for physical therapy, speech therapy etc. that is not related to rehabilitation of a skill previously had, goes directly under the umbrella of developmental delays and doesn't get any therapy covered. I read the policy. It's right there, in black and white. They don't care if my son ever walks, talks, or feeds himself. But guess what...I CARE.

If you're experiencing the same thing. You need to appeal to you insurance company. Chances are, it will take two appeals before you can appeal to an outside entity and then they make the final say. In addition to that, you or your spouse, whomever carries the health coverage, needs to contact HR at their company and complain. And they need to do that over and over again, until the company (hopefully, but probably won't, realizes what they are doing wrong and makes a change).

Moving on...

Wednesday evening I went to a photography networking event. I mentioned to Isabella that I might wear a dress, she told me that if I wore the dress, then I would be beautiful. Thank you.

Walter has decided to use peer pressure to keep me from doing P90X this week. One night it didn't work, and I did yoga without him, but I must admit, he lured me in with Damages and I haven't worked out for a few days.

Interesting things always happening when I'm trying to blog. Isabella and Isaac were having a puppet show and Isaac has a serious crush on ballerinas, Isabella wasn't sharing the ballerina barbie, so the argument resulted in barbie losing her head. What a shame.


I happen to love punching invisible people, not sure what that says about me, but today I'm going to do Kenpo X (kick boxing) and pretend people from Aetna are in front of me. Maybe someone will lose a head...what a shame.





Walking around the tool table







Waving at Isabella



Only cool people have pink tiles in their bathroom.


Meltdown...



For Christmas, my brother and sister-in-law gave me a backdrop stand and cloth. I decided to try it out today, which led me to believe that people should not take pictures of their own children. The only thing that comes out of it, is liking your children less.

Isabella cried when I took pictures of Isaac and not her, and Isaac refused to give up his remote control for his fire truck.











Stella was much more cooperative and took posing very seriously...





"Stella, I really need to touch your nose..." Isaac is finally starting to identify body parts and he really likes to practice on Stella.





Gotta run, Isaac's unhappy. 



2 comments:

  1. Barbara aka Mom aka GarJanuary 22, 2012 at 12:17 AM

    The insurance coverage isn't decided by the insurance company it is the employer who determined the policy and coverage. The insurance company is just the middle man aka bad guy.

    Interesting. It makes all of us question our own policy's and what the coverage is for our children who didn't break their leg, didn't have a stroke so speech was affected, or couldn't swallow food because they don't know how to take food or drink in by mouth. Not a topic most of us think about until the need is staring us in the face. Where do our employers stand on issues that affect our lives and what are their bottom lines? The invisible line in the sand. Where is it?

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  2. Picture #3? Amazing. The two color ones before the pics of Stella? Doubly amazing! Isaac and Isabella have the most beautiful eyes!

    I'm praying that things work out for Isaac's therapies.

    I got a miniature "Rock em Sock em Robots" thing for Christmas...maybe you can glue the Aetna logo on one and then work out some frustration ;)

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