Our son Wyatt was diagnosed with Childhood Apraxia of Speech, a motor speech disorder, at two-and-a-half years old. Other, related diagnoses followed: Sensory Integration Disorder, Self Care Deficit, and later, Pervasive Developmental Disorder. Without therapy, any of these conditions could impact our son’s quality of life and his ability to function on a daily basis. I knew we had a difficult road ahead. I also knew that I’d do absolutely anything to get him the support he’d need to cope and to thrive. What I didn’t expect was the months-long battle with our insurer to cover the therapy that our doctors deemed essential to his development. I’m a post-partum Nurse and I’m dedicated to my patients—mothers and their babies. I always thought that the hospital I work for would have the same dedication to me, the same compassion for my son. Instead we were caught in a web of red tape, denial letters and medical bills—victims of a health insurance plan designed to protect the hospital’s bottom line, not the Nurses it covers.

After the first diagnosis, Wyatt started twice-a-week therapy, , covered by Cigna. His vocabulary at the time consisted of less than ten words. When our insurance switched to Health Now, we were told our son’s speech therapy and evaluations involved would not be covered. Then we were told his Occupational Therapy would not be covered either. We spent countless hours calling the insurance offices, hospital departments and the provider. Then, Health Now claimed that we owed them nearly $90,000.

Another coldly-worded letter from the insurer informed us that “Children with disabilities are (not) covered per policy,” and that Wyatt’s therapy was ‘not medically necessary.’ Wyatt’s diagnoses are the “Result of known neurological impairment, in association with complex neurobehavioral disorders…”* His therapy, and all future treatments, are undeniably medically necessary. We had to cut his therapy in half and sacrifice many things in our life to be able to afford even that.

It was a nightmare.

We never gave up on Wyatt. We did what we could to keep up his therapy, and we kept fighting to get it covered. Two years later we got our first piece of good news: our debt was “forgiven” and the hospital would begin to cover speech therapy. But they can never erase the impact the ordeal had on my family.

I know there are other families in similar situations who didn’t have the resources to wage war with the insurer. We only won because we fought. And that’s exactly what we all need to do now so that we can fix the rest of our broken health insurance plan.

–Amelia Cerda, LDRP

*The American Speech-Language-Hearing Association (ASHA), “Childhood Apraxia of Speech”