A testimony from Shawna who blogs at Not The Former Things
It’s not something you want to hear, but I expected it. When the pediatrician said I needed to take my son in for an evaluation for autism, I wasn’t surprised (I had done my research and had seen the signs and symptoms for years).
Then, to make matters worse, she said, “Your insurance will not cover the evaluation and they can be very expensive.”
After calling her top three referrals, I knew exactly how expensive: $1,700, payable in full and cash only. By God’s grace, I was able to make the appointment, knowing we had the money in savings.
Less than six months later, my youngest son was also referred to a neuro-psychologist for a dyslexia/neurological processing evaluation. We were also able to pay cash (a total of $2,000 this time) when our insurance didn’t cover the cost.
So, how did we do it?
1. We Dipped Into Our Emergency Fund
We paid for both, a total of $3,700, from our emergency fund. Because my husband is self-employed, we keep our emergency fund at $5,000. This helps us with fluctuations in his business and ultimately, is back-up in case he is not able to work.
It was tempting to just pay the doctors with credit card advances to preserve our savings, but we knew that God wouldn’t give us these boys with their unique needs, without providing a way to take care of them.
2. We Cut Back Our Budget (way back!)
In the months between and following the two evaluations, we worked twice as hard to build back up our savings to the $5,000 mark. I will admit, it was so frustrating to finally get close, and then have another expensive evaluation required.
We had to cut back on everything – the boys and I stopped eating out and my husband only did so as work required, my husband sold his car to fund our Christmas and increase our savings, we cut the grocery budget by 30%, and we didn’t take an anniversary trip we had planned.
3. We Encouraged Each Other To Focus On What Was Important
The thing about having your son diagnosed with high functioning autism and then your other son diagnosed with a learning disability/processing disorder is that it really puts things in perspective.
When one of us would get frustrated with our financial situation, we would remind each other how grateful we are to finally know what is going on with our boys, and how much help we are receiving as a direct result of those costly evaluations. This made the desire for a new couch, or even extras at the grocery store seem silly in comparison.
It may not have been easy, but truthfully, we would have paid more for the peace and direction these evaluations have given us. We now know how to help our boys and what resources are available to our family.
The reality is that we continue to dip into our emergency fund again and again for various, not covered by insurance, therapies for the boys. The good news is that we are getting more practiced at how to live in the flux, and accept this as part of our financial life.
I am so thankful that we committed to create and maintain that fund. Staying out of debt and funding that account literally changed our family’s life.
Shawna loves Jesus, her husband and her two, uniquely challenged little boys. She finds herself daily, required to live beyond the limits of herself and serve a wonderfully complex family…and she is crazy rebellious in this most of the time. She blogs about the messy and the beautiful at Not The Former Things.
Have you saved up and paid cash for something — large or small? Submit your story for possible publication here.
This is a wonderful story of how parents do whatever is necessary to make sure their children get what they need. It makes me sad to read that the costs are so prohibitive, though. I live in NY state and have a nephew who is autistic; the access to services here is very good and the out of pocket cost for my brother and sister in law is minimal compared to other parts of the country. I can only hope other states follow suit and access to needed therapies becomes less of a financial burden for families.
If you have a choice of health plans, check and see if one of those has better coverage for your sons therapy. I did this last year, and by paying a slightly higher premium we were able to get coverage for some of our sons therapy. Good luck!
I’m glad you had the money to pay for the evaluations. What a blessing! From the financial side of things, I’d suggest that you now start a fund/budget category just for these “expected” medical needs for your boys. And I would still keep the emergency fund for emergencies or unexpected expenses. It may sound like a minor point, but I believe it’s important to keep an emergency fund for big surprise expenses like job loss, car accident, mother nature’s effects, sudden medical expense, etc. And once an expense becomes somewhat routine, it should go into the budget.
I hope that makes sense. Hope your boys get the intervention they need and have a bright future ahead of them!
There are tons of people across America going through these same issues. Alot of people never realize how fast deductibles & copays add up. It’s sad that after having huge portions of a paycheck taken each month for premiums that more is not covered. But, I look on the bright side that all of our past medical bills would have put us in to bankruptcy had we not had it. So the 10k (plus) we’ve spent OOP seems so little really.
Thank you so much for the supportive comments and all the wonderful suggestions! I am grateful for this opportunity to share our story, and I am excited to learn more about how we can navigate the financial part of our journey.
what a wonderful story! my son also is high functioning autism and mild Cerebral Palsy. Except for a $20 copay, I am so thankful our insurance covers it all
Lora C says
Thank you for this post!! I finally got health insurance at the beginning of the year after more than 10 years without any health insurance. Unfortunately, I have had some major healthy issues since getting the healthy insurance–these have led to a number of expenses that have not been covered by the health insurance. Your post helped me with my “plan” for dealing with these expenses and it reminded me of how grateful I am to know what is going on with my health.
Laura at TenThingsFarm says
I would encourage anyone whose children might have special needs to contact the local Head Start program. Head Start is primarily a preschool program, but in many communities there are other programs, such as Early Head Start that will not only help with a lot of the screenings and evaluations, but will also have programs to help young children and their families in those early years. Where I live, many of the screenings are free through the program if certain risk-factors are identified (examples would be things like speech or language delays, lower motor function, etc.). If a child has special needs, the income qualifications for Head Start do not apply. It may be worth checking out if you have questions or concerns, and it won’t hurt to call and inquire. 🙂
Matt McWilliams says
The best part about this story (to me) is that an already stressful and difficult situation for everyone involved wasn’t made worse by panicking about money. I love that!
Money isn’t everything, as Zig Ziglar would say, but it’s right up there with oxygen.
Great post! Does your area have a Children’s Dyslexia Center (a Masonic charity) nearby? if you have the proper diagnosis you can get up to two years free tutoring for your dyslexic son. The site address is childrensdyslexiacenters.org. As a special education teacher the training I received there was wonderful, and I got to tutor some amazing students!
Good for you for being proactive and getting your son the services he needs, and for having such a great attitude about it. I have a brother with autism and I was a special education teacher (I taught a class that was primarily children with autism), and if I learned anything at all, it was that involved parents make a HUGE difference. Keep looking for the positives, Mom! You’ll do great.
Also, if your school age child is high functioning make sure you have an IEP in place at school so he can get services and support there. Good public school districts usually have a wonderful support team that can help tremendously!
Some states now have laws now that say insurance companies that offer major medical have to pay for treatments and evaluations. New York being one of them. Before this new law in NY state two years ago, I took my then 10 year old son to a private psychologist who specializes in diagnosing kids with autism. At the time, he was having major anxiety issues. We did not know he had Asperger’s at the time, but suspected it. We were fortunate that insurance covered the diagnosis and any related mental therapy, including attending a weekly social skills group because it was coded as anxiety due to other health impairment. He still goes today and we only pay a $20 copay each time. He also is on a daily med, which is about $10 a month. Of course, this adds up but small price to pay knowing he is getting the help he needs.
Wow! I had no idea that these sorts of bills were not covered by insurance. Somehow that just does not seem right. Kudos to you for paying cash!
This hits a little too close to home for me–7 weeks ago I delivered a son diagnosed with pulmonary hypertension (PPHN); his case was particularly severe and more than once we almost lost him. Thankfully after four weeks, three hospitals and two emergency transfers (you don’t even want to *know* what that costs) he appears to have made a full recovery, but we were told that the month he spent in a level 4 NICU should be somewhere in the $700-900K range. The bills are just starting to trickle in and there’s so many things that aren’t covered, are out of network or have specific riders in our insurance policy. We wouldn’t trade our son for anything, but the reality is that this is going to have a long term impact on our family finances.
just said a prayer for you! I pray that you can feel the joy of motherhood instead of the financial stress. Praying God will meet your financial needs.
So glad your son is doing much better now. I completely understand how medical bills seriously impact finances. My mother is diabetic and she went through a really bad period where we kept needing to take her to the hospital and those bills for us really added up nothing compared to what you are looking at. However when we went to start making payments we expressed how hard it would be to pay some the higher bills and the billing clerk told us about a fund they called “The Sick and Needy Fund” we didn’t like the name very much but the billing clerk was really nice and said that our situation was exactly what this fund was created for. So we applied to it and it helped pay a large portion of the bills. Maybe the hospitals where your son was treated might have something similar it never hurts to ask.
Please don’t accept those bills as non- covered by insurance. I’m a RN who used to work for an insurance company and know that a lot of things will be paid if you call and ask questions. For example, out of network care should be covered if no facility in the network could provide the services your son needed.
I’m so sorry you’re having to go through this. My daughter recently spent a week in the hospital and the stress of her illness along with having to question multiple medical bills made me feel helpless. I just said a prayer for your family.
I’m also thankful for this post! Until I had a son with special needs, I never would have been able to guess the high costs that insurance refuses to cover. We also have a high-functioning son on the spectrum, and he has only come so far due to the early interventions for which we paid cash because insurance covers so little (or nothing) when it comes to autism. Our son now attends a special needs preschool that clocks in at $1850 a month; it’s worth it, but it took some major adjustments to go from a few hundred a month in therapies to nearly two thousand. Instead of focusing on the tuition as a bill, I worked hard to shift my perspective to instead view that monthly invoice as conscious spending; we are extremely blessed to be able to *choose* these amazing treatments for my son. It grieves me that early interventions are proven to change the course of a child’s development, yet so many families do not even have these options because they simply cannot afford them.
Good luck on your journey, Shawna!
Great article and kudos to you for being a good mother to both of your children! Please tell me why this is not a covered expense by insurance companies…autism is now 1 in 88….
I am so thankful for a post like this – evaluations (and therapies and anything labeled “autism”) are SO expensive! What a great testimony for this mama.