Problems with Insurance Reimbursement

By Mark Hutten, M.A.
Question

My son has Aspergers, and I am having problems getting my insurer to pay for specialty medical treatments that should obviously be covered. Do you have any suggestion?

Answer

Unfortunately, this is not uncommon. I have found that parents with Aspergers (high functioning autistic) children not only have a tough enough time locating a good referral for either diagnosis or treatment of the disorder, but they also have problems with insurance reimbursement.

Sometimes, parents simply need to do some good old fashion “ranting and raving” to get things done – seriously! When parents are in HMO's and they are only offered low level assistance by therapists who don't know about Aspergers – it’s time to get tough.

Find out who in your area is an expert on Aspergers and demand that your insurer pay for that person (even if they are out of network). It’s up to YOU to make sure your insurers will pay! If you are in the U.S., ask your State Insurance Office to help you. Keep notes on all phone contacts with your insurer (always ask the name of the person you are talking to), and if you are getting nowhere, file a complaint with the State Insurance Office.

The Aspergers Comprehensive Handbook

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