On Tuesday, April 12 Samuel celebrated his 4th birthday! He went to school that day where the class sung Happy Birthday to him. Later that afternoon his grandparents gave him a birthday celebration where he enjoyed chocolate cupcakes. We gave him a family party on Saturday at our house as his grandparents, aunt, uncle, and cousins celebrated his special day. Samuel especially enjoyed blowing the candles out. We didn't know how he would do with others in the house, but he handled it very well. I'm not sure if he understands the concept of a birthday, beyond the cake and candles. However, he enjoyed saying "Samuel's birthday" over and over.
Today we took him to his pediatrician for his four-year old checkup. We have been very blessed that he has been a healthy child. In fact, this was the first time he has been to the pediatrician since his three-year old checkup, which is when they referred us to the autism specialists. Today he received another healthy report all around. He also was given the dreaded four-year old shots. Beyond a brief crying spell, he handled the shots and the entire visit very well. He is now immunized (beyond seasonal flu shots) until middle school.
On October 15, 2015 Governor Pat McCrory signed into law S.676 requiring certain health insurances (including the State Health Plan) to cover the screening, diagnosis, and treatment of autism effective July 1, 2016. One of the treatments for autistic children is called Applied Behavioral Analysis, better known as ABA Therapy. This is an intensive daily therapy that costs thousands of dollars. We have been attempting to get Samuel into ABA Therapy since December. Our neighbors have been using a local company for several years and have had very positive results. We contacted this company and they are ready to start with Samuel once our insurance approves them for in-network coverage. This was suppose to be completed in no more than 90 days. The company contacted me several times over the past three months saying they were still trying, but were waiting on the insurance. Early last week, I received another call from them saying that the insurance was currently not accepting new in-network providers in our county. Therefore, I started calling Blue Cross (State Health Plan) to find out more information. I discovered that currently there are only 42 providers in the entire state that they have approved and none within 50 miles of where we live. At this point I reminded them of S.676 and stated that my son should not have to wait while the insurance company drags their feet to provide coverage. I was then directed to something called a "Continuity of Care" form. It was described to me as an option for individuals that live more than 50 miles from an in-network specialist. The company we are working with can simply complete a form with Samuel's information and submit it to the insurance. If approved then we can receive in-network coverage without it being officially listed as such. This process is now beginning and we will see where it goes from here. Although this is a fairly minor setback in the grand scheme of things, it gives me a glimpse into the struggles that so many families face daily with illnesses and wondering if their health insurance will cover the treatments.
On a lighter note, this Saturday is the 6th Annual Coastal NC Run/Walk for Autism. Many of you have sponsored Samuel in this event. We are very excited about participating and spending some quality time in this worthwhile fundraiser. I will let you know in the next post how everything turned out.
As always, thank you for taking time to read. We have an incredible support system and we are most grateful to all of you!
Till next time,
Brian
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