My Autistic Boy And Other Adventures In Fatherhood

So this blog ‘cutting off’ image has me befuddled. I just did a redesign about a month ago and now - whammo! - all of a sudden everyone on a PC is having issues.   Mac users - no issues.  What to do? I’ll play around in the next day or two a little bit with it.  Overall, most everyone is seeing the blog text cut off, which is what I’ll aim to repair. I doubt I’ll do a major reinvention again any time soon.  I’m gathering most of you can still read it, and want to read it…but if you guys demand a major change, I’ll do it.  I am, of course, here to serve.

—–

I left corporate America on February 1st, and have been on my own since then. It has been a nice change (beset with a new group of worries, but refreshing none-the-less) and we’ve been doing okay.  That said, it has been interesting with our insurance provider.  Now, we’ve been making COBRA payments on time, since they’ve become due - funny though, almost every single therapy session has been kicked back to us. In fact, in mid-June, we started receiving denial/non-payment paperwork all the way back to mid-February. Very interesting….Kim is our in-house guru on dealing with insurance companies - I’m sure we’ll get it all worked out, but I find it funny that as soon as I’m not on the corporate payrolls - well, you follow my drift.

Oh, and Demetrius now is turned down for therapies. They aren’t essential anymore.  Again, funny how this works this way. Never been ‘non-essential’ previously…but I wasn’t COBRA payment-ing previously, was I?  We’ll see on this too…..we can argue for it (luckily, we’ve taken Demetrius out for the summer, he’s in alot of camps and vacationed at the beach, etc…) but we probably won’t do that until we get ready for school to begin in mid August.

—–

I did some grocery shopping before Kim and the kids got back and I picked up the ‘wrong’ type of ice cream, a low-fat/no sugar version of chocolate, made with Splenda.  Anyone have any issues with their wee-ones and Splenda ice cream? Any wiggin out by your auties/aspies?  About 1/2 an hour after he had some Demetrius got real whiney, then he wanted to wrestle for some sensory integration, then he went into a giggle mode like I’ve never seen, all tied into some weird behavior (he kept taking his head and putting it under the bathroom faucet and squealing and laughing…right after his shower).  We were a bit dumb-founded and Kim thought it might be the Splenda. True.  So I’m asking ya’ll. Also, it could be that he was up past 12:30am on Saturday night after getting back from Kansas on his flight, so he might be way tired too…and it manifested itself this way.

Anyone got any ideas?

So, as you know, I’m getting my small consultancy biz up and running. It is going well on the biz end, but I’ve talked to three different insurance brokers, all with different angles/insights into the marketplace and all came back and told me that, from an individual plan standpoint, Demetrius is uninsurable.

And then this story just showed up in my inbox.  Timing is everything in life, ain’t it.

Alot of you have given me good advice on options to take, that might make it workable. Some of the solutions (when COBRA finally runs out):

• Form a small business and thus a small group plan (have Kim come to work for me)
• See if I can join a ‘group plan’ that is often offered through local chamber of commerces
• See if Kim may want to go back to work to be able to get insurance through her employeer (other than working from me)

I’m not sweating this, really, on 4/23/08.  That said, it was disconcerting to be told no, so quickly by these three guys.  That’s a bit rough.  But that’s life, ain’t it?

A few of you (most in 1:1 emails) have asked me what I’m going to do ‘job-wise’ by this set back in re: to the insurance situation?  As it stands right now, as I said re: COBRA, there isn’t anything that I ‘have to do’ right now.

The hope is in the next week or so that I can sign up a few more clients, and that will give me good insight into my opportunities to be a small businessman.  

However, I have spoke to a few people (including the grown ups, my parents) and am related to an example that might be one of the options.

First: Kim could come to work for me, as I posted yesterday, but we don’t know what the requirements of that are.  Does she have to be full time? Does the company need to be incorporated a certain way?  Those things just need to be explored or thought about, if we do decide to go this way.

Second: Kim could become a teaching assistant at one of the local elementary schools.  This way we could get on the ‘govt. dime’ and use that employment resource for insurance.  I was reminded (here’s where my conversation with my father took place) that this is a very similar to many people he knows in his life …and also similar to my in-laws (my father-in-law is self-employed, my mother-in-law works for an agency that supports the govt. of the great State of Kansas).  The in-laws are on her insurance, which works for them.

So what to do?  Well, we’ll see on those clients, and then if the assistant teacher route is the one we want to follow, then Kim has to begin researching the reality of that one immediately. 

And who is to say that the self-employed route makes me an entrepreneur for the rest of my life…or over the months I have COBRA?  Who knows if I end up taking another corporate job, cuz I can’t make the numbers work, and these past postings are all for naught?

So many things to consider…

Anyway, about ¾ of you like my news postings.  So here are a few from this past week:

Whew!

We all know Legos are simply the greatest toys in the world.

WitchyPoo, you Canuck….this might interest you in particular.

Dogs and autistics….one of the reasons Buddy came into our life was to add a dog to the tools to bring Demetrius out of his shell….Once in awhile Demetrius is interested in Buddy.  But here’s a story on one of the theories.

Interesting research on eye gene roles in autism…..

That fast I was knocked to the floor.

Yup, that friggin fast we were turned down by every major insurance carrier there is: United Healthcare, Aetna, BC/BS (others too)…

Here is what we were told (I am not sure exactly which carrier told the rep what, but this is what he shared with me):

• In the pre-screening email I cut and pasted below a few just gave the stiff arm as soon as they read the word ‘autism’
• One gave us a hard ‘no’ when they saw that Demetrius was on two meds, and which two he was on
• Another would consider us if Demetrius was only on one med. Since we are testing one of the two meds, we resubmitted, and we would probably have to do a screening interview. However, once we got to the boy’s date-of-birth, we were denied due to his age (they would have accepted this single med if he were an older child)

Interesting point the rep told us was to be careful with doctors when with a small company or individual plan, trying meds can get you denied. The doctors don’t take insurance ramifications in their consideration sets when prescribing. That’s just good information, I think, to share with ‘ya’ll’.

So where does this leave us, the family, and my dream of self-employment?

Well, at this time, as of today, it isn’t necessarily a worry or dream killer. I have months and months and months of Cobra insurance from my former employer, though it is anything but cheap.

Further, group insurance might be an option. If I can grow this baby, I can add Kim as an employee, and then offer her insurance. This would qualify us for a ‘group plan’ and it would be easier to get Demetrius and the family onto this plan. As long as the carrier accepted pre-existing conditions. That’s a bit of a big ‘what if’ ain’t it?

I am sure I can get Kim to be my office manager. I bet she would love taking direction from me….also, I wonder, if I could give her annual reviews and progress reports?

I’m strictly talking about office work, of course.

More of this to be played out in the future…..

Here’s what has been submitted…important to know I’ve cut out some of the vitals, as I don’t want to make EVERYTHING public to you guys.

My son is high on the autistic spectrum, attending Fulton County Public Schools and is in a mainstream first grade classroom (he is a high functioning autistic that is verbal and does typical mainstream class work and has the requisite social and speech issues associated with autistic children).

Once a week, my son gets speech and occupational therapy, for an hour each at Kiddos Clubhouse, billed to our existing health insurance provider (not out of pocket).

Roughly 3-4 times a year he sees Dr. Amy Pakula, his special needs pediatrician, at the Marcus Institute in Atlanta.

He also takes two medications.

Now we wait to see what the insurance carriers respond with after this submission…yes, no or more information needed.

Kim also saw a lead in on GMA about this. Now its gaining some publicity

I’m very much considering starting my own business.  I’ve done this in the past in 02.  I think now, as in everything in life, I’m a little more experienced, a bit more confident.  I think I can make a go of it…but then there is the insurance question re: the autism. 

You know this is staring you in the face, but the phone call is what it is when it happens.

You start having the conversation - 38, healthy…same for 38 year old wife….but then when you get to the kids….

“Okay, to have you considered, I’m going to have you put every detail you can in an email about your son. Meds, therapies, number of trips to specialists…everything you can.”

Ugh.  What’s that feeling in the pit of my stomach? Oh yea, it is ‘bad experience’. It never digests and always comes back to haunt me….

I’ll keep up with telling you guys what happens here.  This should make for some good postings.