Anyone with Aetna PPO insurance for autistic kid? (Clarksville: how much, to buy)

[Anukrishna208]

Hi

I have Aetna ppo plan for my son, but it's is not covering speech therapy for autism cases. Anyone has similar experience with Aetna ppo? Can you please suggest on how we can opt for private therapy with this insurance plan?

[centralaustinite]

We have Aenta PPO and it only covered speech for my son up to age five, after that we had to do private pay. My son isn't autistic but has severe dyslexia that impacts how he processes phonemes.

We were able to negotiate private pay speech therapy at $100 an hour.

[clarksvillemom]

similar to above, we worked out private pay at a discount with Central Texas Speech Pathology Services, Inc. | Lisa Famiglietti. also have Aetna

[Anukrishna208]

Clarksvillemom, how much they were charging? My son is completely non verbal for now, I think it will be very expensive for complete private pay for the number of sessions he will need :-(

[clarksvillemom]

not sure if this is dependant on the certain type of insurance we have, but I think around $100. But Lisa tried to get Aetna to pay first, so maybe she can get them to reconsider their denial.

[mrsengle]

$100/hr for speech therapy? We paid $45/hr private pay for in-home ABA (3 years ago, but still)!!!!

How old is your son? Have you tried Easter Seals?

[centralaustinite]

Originally Posted by mrsengle

$100/hr for speech therapy? We paid $45/hr private pay for in-home ABA (3 years ago, but still)!!!!

How old is your son? Have you tried Easter Seals?

That is pretty much the going rate for private pay, remember though, most speech therapy sessions for children do not last an hour, 30-45 minutes is typical. And your child may need more intensive therapy at first, say three 30 minute sessions a week but only for 6 months and then less. So the costs can go down over time.

OP, you should at least talk to private therapist at some point, many kids need both public services and private. Often the most expensive part is the evaluation -- hopefully the school district will do that, if not, some insurance will pay for the evaluation even if they won't pay for the subsequent therapy.

[COCUE]

We dont have Aetna but have been on Cigna and also BCBS on private pay and paid $45 for each 30 minute session. So $90-$100 for an hour session is pretty normal. You just ask the clinic that you want to private pay since your insurance doesnt cover it. Pretty simple. But as everyone said, start with the evaluation. Even with insurance that didnt cover speech services, they covered the evaluation. Good luck!

[Anukrishna208]

Thanks for all your suggestions. I am thinking to go for private pay ( 45$ each 30 min session in capital area speech) for now, and try to buy a new insurance with speech benefits sooner.

[ashbeeigh]

Originally Posted by mrsengle

$100/hr for speech therapy? We paid $45/hr private pay for in-home ABA (3 years ago, but still)!!!!

How old is your son? Have you tried Easter Seals?

I would also reccomend contacting Any Baby Can. If they do not have speech therapists (I don't think they do) they will have resources for you, even beyond those needs you have mentioned before.