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My son just got diagnosed with autism and sensory processing disorder. We've been doing OT through EI but I feel he needs to go to a sensory gym. My insurance company doesn't cover it. Does anyone have any tips on how I could get them to cover it? My husband is able to choose a different insurance plan in November. Can anyone recommend an Insurance company that covers therapy? Thanks so much!!
Thank you!
who ever is submitting it, they should know how to do that. There are hoops and the way it's worded and why they need it.
@A MyAutismTeam Member I'm in CA too, with insurance through Kaiser. I don't know if it's mandated by the state, but Kaiser does cover OT **if** it's for daily life skills (DLS). So, not for body regulation/gyms/educational purposes, more about bathing, toileting, dressing, eating/feeding, getting around, personal hygiene/grooming, sleeping, etc. What's covered is relatively limited in scope, given all that occupational therapy can be useful for.
Is this by state? I'm in CA and OT is covered for an autism diagnosis.
Hey there! I've been trying to get our insurance provider to cover OT as well, to no avail. My understanding is that insurance will only help with OT if the need is for Daily Life Skills (DLS) support. Otherwise, OT is out of pocket or through the school district via IEP.
As an alternative, there's a kids gym called We Rock the Spectrum. Have you heard of it? Looks like there's a location in Waldwick, NJ -- http://www.werockthespectrumwaldwick.com/. We have one sorta neaby us and really enjoy going there to burn off some energy in sensory supportive ways (re: swings, trampolines, a zip line, train play room, etc.).
Good luck!
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