My daughter’s health insurance company couldn’t care less

September 29, 2014

hearingOPINION By HILARY GRANT

Looking back, it all began when my smart, beautiful and spirited teenage daughter was in first grade.

Her teachers told me Katie could hear perfectly well, but darn it, she just didn’t listen. Treated as a behavior problem for years, I now know that, in fact, my child was physically unable to listen.

My daughter suffers from Central Auditory Processing Disorder, often known as CAPD. Recognized as a bona fide disability by the Americans with Disabilities Act, Katie hears fine, but her brain has a difficult time processing words and ideas.

There can be a genetic link to this learning difference, and it is also common in children who have suffered from multiple ear infections at a young age. Or, like Katie, it’s common for children who lived in orphanages for the few months or years of their lives, often starved, and then, like my child, were finally adopted. Katie was nine months old the day I took her home from China.

Although lots of folks have never heard of it, CAPD is a very big deal.

Why? For one thing, the specialized audiologist who diagnosed Katie believes up to 70 percent of those in prison suffer from some sort of learning difference that was never diagnosed and never treated. I’m a pretty cynical cookie, but this figure astounds me.

Still, it makes sense.

After all, kids with CAPD, and other learning differences, often do poorly in school, suffering from short-term memory, an inability to take notes and crippling test anxiety.

The good news is that CAPD can be successfully treated. With a trained specialist working one-on-one with a child, along with equipment that includes special CDs, headphones and other auditory props, permanent improvement can often be seen within a few months.

The bad news is that most health insurance companies—including MediCal, which my daughter has, or California Children’s Services, which is supposed to cover what MediCal won’t—refuse to pay for either diagnosis or treatment costs, which can quickly add up to several thousand dollars. This, despite the fact that CAPD is a physical impairment that affects learning and living, just like being deaf or blind affects learning and living.

No child wants to fail school. But as long as physical learning differences are left uncovered by health insurance, tens of thousands of children will continue to go undiagnosed and untreated. This is a recipe for disaster into adulthood.

I’m just one mom crying in the desert. So, I created an online petition to demand that children with these physical impairments be covered by health insurance companies. It’s a small start, but it is a start.

Scrape a few million dollars off the obscene bonuses made by health insurance CEOs, and I promise you, the money will be there.

Please, sign my petition at change.org.

Hilary Grant is a writer, cookie baker and mom who lives in Los Osos

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gangsta1

It is high time that this country take care of the medical needs of all U.S. citizens. Be it a learning disability or whatever the case may be. Be it on medical or fully high priced insurance. This old “well, you had the kid it’s your problem is B.S.. This country allows many illegals to cross the border paying for births of kids and footing the bill for years of support. Medical,housing,education. What happened to respect for your own. Give me a break, “I will gladly sign your petition” and I hope you get the care you need AND DESERVE!!


nurse1

gangsta 1, and where does that $ come from? I agree with you on the border issues etc…but kids are kids right? This child came from China. Where do you draw the line? Or should there be a line? I suggest moving to a socialistic country until we get our health insurance and affairs straightened out. After all,they have the all perfect system, right?


OnTheOtherHand

Based on health outcomes for the general population, several of those countries actually are better than the US (although not perfect). I don’t know that such a system would work here — mostly because of the ineptness of our federal government at running any massive program — but that doesn’t mean it doesn’t work elsewhere.


JMO

Hand, if you are referring to China, everyone in China has to pay for their health care. No freebee’s there. Granted, the cost of health care is reasonable, but no one gets a free ride. Just like there is no welfare there. No work, no eat. And they aren’t going hungry there. They all work.


3 putt

“this child came from China” ????? This child was adopted !!!!!


Do you have ice water in your veins? I suppose you are American Indian. Sheeeesh


cowtipper

This country was started by immigrants. A racist nurse, no thanks.


celeryclown

Also, CEOs of health insurance companies are making BILLIONS on bonuses — and YOUR premiums for paying for that. I am an American citizen and so is my daughter (automatic when I brought her home). We should have universal health care like every other developed county in the world — but heck, that’s ANOTHER Opinion piece. :) Hilary


cowtipper

The GOP is to blame… and they are beholden to the insurance companies.


achillesheal

We have a great educational resource in SLO that has done extensive work with CAPD kids – Lindamoodbell. Instead of to Doctors, consider taking your child there. You will have to pay them, though.


pasoparent5

We spent many thousands of $$ there for tutoring and simply couldn’t afford it anymore.


The tutors were great but trying to deal with the high pressure managers felt like sitting through a condo timeshare sales presentation. Lots of guilt, mediocre results, and VERY expensive sessions.


After that experience, I wouldn’t recommend the place to anyone.


celeryclown

Hi, Hilary Grant here. Linda Mood Bell is EXTREMELY expensive. We are now working with Kris Furbee in Los Osos, who has been doing this work for 20 years. She is awesome. But of course, we do have to pay out of pocket… much, much less than Linda Mood Bell, though.


isoslo

Although I sympathise with Hilary I have a few questions. First you are on medical not private insurance. Medical was designed to give bare bones care for the poor, not to give top notch care to everyone for every condition. I checked with my blue cross policy and although they cover CAPD it is confusing as to what they will pay for, something about medically necessary versus non medically necessary. Maybe you should get the better insurance and give up a few other expenses to cover the cost. Second isn’t your father Jim Grant, a highly compensated ex city of SLO employee, maybe we as a society should look to family before we expect the free government insurance program to pick up the tab. Third I have a friend whose son has the exact same condition, although it has been difficult he and his wife have sacrificed greatly in order to get their son the treatment he needed. The treatment was mostly education and diet, neither of which are covered by insurance. Some might say I am being cold but we as a society have choices and all of those choices have costs. Should treatment of CAPD be a medically covered expense and if so do we all need to pay more to cover it. One of the reasons many of us strive to make more is so when life deals us difficult hands we have more ability to get what we need by having more financial resources.


celeryclown

Thank you so much for reading my Opinion piece!


But first… I am no relation to Jim Grant.


Second, please note that NO health insurance company covers treatment for learning

differences with an education specialist.


A few may pay part of the diagnosis cost (for us, $750 out of pocket) but none pay for education specialists who work with CAPD, and other learning difference, kids. Costs of equipment, also out pocket and also not paid by insurance, has been more than $200.


As far as your insurance covering some parts of CAPD, these days, health insurance companies are in the business of NOT paying claims. It’s all about profit. So, if I was a betting woman, I would bet that your health insurance company would fight you tooth and nail bbefore you’d see a dime.


Third, if you’re looking at this from a cost effective viewpoint, and I get that, it IS an important consideration, isn’t it better to give children who have learning differences the treatment they need, rather than kick the can down the street and later on, pay the much greater cost to keep someone in prison?


nurse1

celerlyclown….seems none of these posts are going to get you your daughters care. Perhaps a suggestion that folks that are so willing to condem the system (whatever way you think) should put their $ where there mouths are and contribute to a solution?

I am sure you would like to see a long term fix to this problem, but can bet a better penny that you would like to see an immediate solution for your daughter? Am I right?

I also know that if you get a PT job at Starbucks they will give you FULL health insurance. Much better then relying on Medi-Cal. I am by no means discrediting what you do but looking for immediate solutions as we can all comment and talk all day long. You say that no NO health insurance company covers treatment for learning

differences with an education specialist.I am suspecting you would like immediate help for your daughter? Am I correct? There are many programs that deal with this sort of diagnosis. Since you are a writer and a cookie baker, would it be fair to ask you if you could relocate to get the care needed for your daughter?


nurse1

My apology. Have celeryclown and Hillary mixed up. Regardless, why not start up a Pay Pal account?


celeryclown

Hi, HIlary and Celery are the same! Please understand that NO INSURANCE pays for treatment of learning differences, and very, very few pay for diagnosis. I am already working part-time and earn more than I would at Starbucks. Also, I don’t know if you know anyone on MediCal but most people I know are on it these days!!!!!


celeryclown

Hi, HIlary and Celery are the same! Please understand that NO INSURANCE pays for treatment of learning differences, and very, very few pay for diagnosis. I am already working part-time and earn more than I would at Starbucks. Also, I don’t know if you know anyone on MediCal but most people I know are on it these days!!!!! I don’t want money — I just want people to be educated out there!


cowtipper

You are on the forefront of making your cause known. Thank you for that. You know that you will have a huge battle to those that think your special circumstance disrupts their sense of entitlement. By making your situation real will hopefully wake up our central coast residents.


nurse1

isoslo. THANK YOU.


womanwhohasbeenthere

Very interesting article, and my heart goes out to the author.


My daughter had a vision problem that went undiagnosed for years. Every year at school her vision was checked, and I was told she didn’t need glasses.


Fortunately I have a cousin who is an optometrist who, when we went back east for a visit, also did an eye exam on her a few years ago. It turned out that while she could read the chart letters back to the doctor, when it came to reading she really struggled. All it took was a few probing questions to see the disconnect.


Now she has reading glasses that somehow help her keep the letters straight, and her reading comprehension has gone up considerably.


All I can say is, if your child is having problems in school, please consider my experience and that of the author’s.


celeryclown

You definitely do get it! Thank you for posting! Best to you, Hilary


achillesheal

Tough challenges for a young child and mother to face.


This may be an unpopular opinion, however, I strongly believe that one of the primary responsibilities with having a child is to be able to financially provide for that child’s well-being.


Being a writer, a cookie-baker, and loving mom are all wonderful things. You also need to go out and earn enough money so your child can be off medical welfare and you can write a check to the Drs to get the child the care she needs regardless of whether the insurance companies cover the cost.


mkaney

Although I agree with you in principle… the same system that serves up the welfare also serves up so much regulation that obtaining services like these is cost prohibitive even for someone with a good income. That being said, if this kind of trained help is really important and the money is not available, there is nothing stopping the parent from learning the same information and skills of the professional practitioner. Maybe not ideal, but such is life.


celeryclown

Someone with “good” insurance and a good income could not get help, either.


celeryclown

You definitely do get it! Thank you for posting! Best to you, Hilary


nurse1

That does not make sense celeryclown?


casappleton

try having a child with special needs….then it makes sense


zaphod

one of the primary reasons we have a government of people and by people, “promote the general welfare” to take care of each other. not neccisarily who can corner a market and create the largest pile of money. no one is alone truly


zaphod

you have entirely missed the point of this opinion piece


achillesheal

Welfare in the constitution means happiness, prosperity and well being. The founders believed that our system of government would and should promote these issues and government should not oppress its citizens.


What you are speaking of is providing specific welfare. Congress has the right to do it with its power to tax, but don’t confuse that with an obligation of those who work and pay their bills to provide everything for those who don’t.


nurse1

mkaney THUMBS UP!


euroamerican

I think you would have enjoyed the Perspectives in Leadership Forum with Dr. Ben Carson at the Reagan Library yesterday…….


zaphod

Huh?


celeryclown

We are doing that. This petition is not about covering my daughter’s medical needs — it’s more about getting word about learning differences and the fact that no insurance company covers treatment for them.

I would like to think that we might be on the cusp of changing this.

Insurance companies didn’t cover treatment for autism a few decades ago — and now, the do, at least to some extent.


nurse1

I respect the fact that you would like to change the system but also am in bewilderment when you say that “this is not about covering my daughters medical needs” huh? Sorry, I have 4 children, (adults now) my FIRST thought would be taking care of my children s immediate needs. ~~Just sayin~~~


zaphod

some folks want a better system for all children not just their own selfish ends.


nurse1

zaphod, this woman has clearly demonstrated a need for her child. Do you REALLY think that this is about a long term solution at this point? If given the choice of helping her child right now or offering a long term solution down the road, what do you think it would be? Of course we would like the best of both worlds, but lets get SERIOUS. How about helping her child right now,, and then looking at long term for others?


nurse1

ya think?


3 putt

Insurance companies have gotten really, really good at being really, really bad!


The idea in the beginning was to”Spread the Risk”. Now it’s Profit/Money.


euroamerican

Maybe it is Medical that has set the limits to what medical help you are able to receive for learning disabilities. After all it is a State run, and Tax payer funded agency. I admit I know nothing about Medical so I am uninformed…..


Mrs. Grant is in a very difficult situation with her adopted daughters needs. I wish her good luc,k and will definitely sign her petition.


I had two children with disabilities it is a hard task. It is not just hard to find the right help your child requires to advance their academic skills, but also their self esteem.


nurse1

You can blame it on insurance companies, the government and everyone else all day long. This is not going to be popular to say but whatever happened to personal responsibility? When I and my siblings were growing up I had a sister with acute asthma, and a brother with rheumatoid issues. My parents moved across the country in order to help my sister and get her out of the extreme weather conditions, and both my parents worked 2 jobs to pay for the care of my brother with his issues. There was no insurance, and if my parents opted to get welfare they would have not qualified as they both CHOSE to work to support the rest of our family. I just get so sick of hearing the blame wand tossed around. At what point do parents take personal responsibility and do what is necessary?


nurse1

3 putt, many of us have not had insurance our whole lives. We have had to WORK and pay for services. Although I do agree, insurance companies, like many companies are in the business to make $. At some point there is something called “PERSONAL RESPONSIBILITY” As much as it can be to our distaste, we can not rely solely on other people to take care of our needs. It is called SELF RELIANCE.


pigsrule

Shouldn’t ObamaCare cover this?


isoslo

That’s funny!


celeryclown

Hi Pigsrule: It should, but it doesn’t — and neither does any other kind of health insurance.


zaphod

that seems to be the point of the petitioner eh?


LameCommenter

I hope your petition is successful. This society should be ALL ABOUT the kids. Prayers for your daughter, of course.


But, the text of my post: Alas, don’t hold your breath. This is the Age of ObamaCare and BoxerCare and FeinsteinCare as I like to call it. I lost my plan, lost my doctor no matter what the liar incompetent in the White House said. Many find your same bitter result for certain unfortunate and rare ADULT conditions, no doctor, no coverage even under the higher premiums.


celeryclown

Thank you! Hilary


GrayGranny2010

Is there a web site or link to sign the petition?


For those of us who have had, or still have, a child who learns differently, we know only too well how difficult it is to get adequate medical services let alone have a compassionate and understanding educational community. I applaud you for doing something and would welcome the opportunity to sign your petition.


Julie