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I had Christian when I was 19 years old. For the first year of his life I couldn’t imagine anything being wrong with my baby. He smiled; he laughed; he rolled, crawled and walked on time. At age one he had a massive overload for his little immune system. He had two ear infections, a high fever, back to back treatment of major antibiotics and he was given his MMR, varicella and HIB vaccines while he was still very sick. Christian faded away for the next 6 months.
At age two he was diagnosed with full syndrome Autism. I met an amazing mother who introduced me to the group Talk About Curing Autism. Before I found out about TACA, I had no clue that there was hope for my child. From that day on I knew that it was my job to get my son back and undue what had been done to him.
It has been three years since Christian was diagnosed with Autism. I had taken what I had learned from TACA, found wonderful therapists, began a diet, found a DAN! Doctor, and took control of my child’s health. I heard his first word when he was 38 months old, and let me tell you, it was worth the wait.
Today Christian attends a typical private preschool. He is the only child in the class with a diagnosis…and none of the other parents know that. He speaks clearly, has friends, reads, pretends on the playground and even knows what he wants to be when he grows up (which of course changes weekly).
I can honestly say, if I had not found that mom (you know who you are), and not been introduced to TACA, I don’t know where Christian would be today and I don’t know if I would ever have been able to help other parents starting this journey. Thank you TACA, thank you my hero mom, and thank you Christian for fighting this with me. I love you.
Chelsi, Washington State
Autism & Insurance
State Medicaid
This is a very important piece of the puzzle. Medicaid can pick up what your insurance company doesn’t pay, including co-pays. Also, if your HMO has strict limits to the number of visits, Medicaid would kick in and pay after those visits have been exhausted, if you are using a Medicaid provider.
Most states have Medicaid (income-dependant) or Medwaiver (not income-dependant) plans available to children with ASD. Learn more about Medicaid within your state and eligibility.
Tips For State-Specific Waivers
Medicaid State Waiver Program Demonstration Projects
This list contains information about state-specific Medicaid waiver and demonstration programs. Users can access fact sheets, copies of proposals, approval letters, and other documents related to specific programs.
For much more information, please see our Who Pays For What information.
Payer of Last Resort
This means that your doctor/therapist bills your primary insurance company first and Medicaid second. Medicaid pays LAST. If you have primary health insurance and try to bill Medicaid first, they will deny the whole thing.
If your primary insurance denies the therapy and it was prescribed by a Medicaid provider – a doctor who accepts Medicaid – the Medicaid will pay it after your insurance company denies it.
Let me be clear, a non-Medicaid provider (for example a pediatrician who doesn’t accept Medicaid) cannot write a prescription for a therapy and it will be covered by Medicaid.
But if the Medicaid provider writes the prescription for it, it will be covered by Medicaid even if your primary insurance denies it.
The most important reason to understand and acquire Medicaid coverage for your child is this: if you have typical health insurance and Medicaid coverage for your child and you get a prescription written by a Medicaid provider for Speech therapy, for example, and that speech therapist accepts your insurance and Medicaid, but your insurance refuses to cover the therapy, Medicaid will pay for it ALL. ALL OF IT.
Alternative State-Funded Insurance
If your state doesn’t have a Medicaid-waiver program and you don’t financially qualify for the straight Medicaid, every state also offers a lower cost HMO-type health insurance. The names vary by state but are generally called the “Healthy Kids” program. They are open to all children, not just those with disabilities. Healthy Kid’s programs can also cover some therapies.
US Department of Health & Human Services: Insure Kids Now!
Coleman Institutes State of the States Developmental Disabilities Funding
Comparison of State's Spending by Kaiser
State-Specific Medicaid Programs
See Listing of all Autism & Insurance Articles
