Therapy Thursday…Tricare Regions


So, as parents of kids with special needs, we realize the importance of good insurance coverage and a good understanding of the good insurance coverage that you have. I have had Tricare since 2006 and am so happy with what we have gotten as a result. I have Type I Diabetes so I was used to the rigamarole of seeing my PCM to get a referral for my endocrinologist, etc. When my oldest son was diagnosed with ASD in 2011, I figured out how to navigate the paperwork maze to get him what he needed. Then my youngest was diagnosed with ASD in 2013 and it seemed like a breeze to get him through all the hoops because I had just gone through it with my other son. Then we moved and it was like hitting a brick wall. Starting over in a new place was hard, getting new referrals and all new therapists was really hard. But we did it. Now, we recently have moved again. This time we actually switched Tricare regions as well. So far so good, but there are some differences in what the regions will cover. Tricare West covered social group sessions hosted by our ABA provider. Here in the North Tricare region they are not covered and we will have a fee each time they attend. Not complaining, just something I wasn’t expecting. Another change is that instead of each of my sons having a set number of hours of ABA therapy a month, there is a set number of dollars per year that covers ABA therapy for my entire family. Regardless if I have one, two, or five kids on the spectrum we get the same amount of coverage. Those with more kids on the spectrum will have less coverage per child. Still doesn’t make a lot of sense to me. So are these changes because I switched regions or did I just find out about them we switched and were setting all our services up from scratch? Who knows. My head is spinning from trying to keep track of it all.

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