Wednesday, January 20, 2010

Manna from heaven

Tasty blue sticky stuff, then brackets.Image via Wikipedia

Auti-mamas, we have been gifted.
Like many kids with autism spectrum disorders, Elmer's medical expenses have way outstripped his insurance coverage; so we're glad to have TEFRA, Minnesota's version of the Katie Beckett waiver. This makes Elmer eligible for Medical Assistance (MA). It's not free; we pay a monthly premium, but it has been critical to paying for his needs. It is considered his secondary insurance, and covers expenses not covered by his primary insurance. As long as it comes from an MA provider.
That's the rub. Because it is a Medicaid program, reimbursements are low and not every provider accepts it. We choose providers carefully, always making sure they accept both our primary and MA coverage.
This short story is getting long.
Anyway, we were delighted that our neighborhood orthodontics office accepted both policies, and Elmer has been going twice yearly for three years while waiting for the last grown up tooth to emerge. Last month it emerged! We scheduled the next appointment, resubmitted insurance cards, and were informed the practice no longer accepted MA. "They never pay," we were told. Folks, Elmer is doing well, thanks to all the supports he has received thanks to programs like MA; but he still has an ASD and is used to this practice and any change is hard and he doesn't want unfamiliar people in unfamiliar places sticking their hands in his mouth.
I spoke to the financial director. I wrote a letter to the orthodontists. And I just got a phone call from the practice letting me know that they were going to treat Elmer f r e e !
They'll collect the $1000 coverage his primary policy provides, but the rest of his orthdontics -- roughly $5000 -- will be gratis.
Gratis! Just like manna from heaven. So I guess that's who I should thank.
(Plus the orthodontists.)
Post script: Because I have been so blessed, I am making a contribution to Doctors Without Borders in honor of these orthodontists.

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  1. Wow - what an amazing orthodontics office! That's not a story you hear every day!

  2. That is awesome. There are good people out there. It's great that the office cares so much about Elmer to be willing to do that for him.

  3. Those are some really amazing people at that office! I'm glad Elmer will be able to go to a place he's comfortable with.

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