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A Small Town Girl

January 9, 2017

 

Ann is a silly, spunky 10-year-old farm girl. She loves "working" with her little brother and parents on their hog farm in Tuscumbia. Ann has epilepsy and has been in and out of the hospital her entire life. In addition to having daily seizures, Ann has global delays and needs speech therapy, physical therapy, and occupational therapy to help her with her daily activities.

 

Ann’s family has private health insurance since they are self-employed.  Ann was labeled with having a pre-existing condition prior to the start of Affordable Care Act (ACA) and was placed into the MO health insurance pool for coverage.  Once ACA came into effect, the MO health insurance pool was eliminated.  Ann's insurance policies started to have a short life of only a year, resulting in having to change insurance policies multiple times with lessening coverage.  Ann's policies have ranged from having no co-pay at therapy visits to $10 co-pay each visit, varying deductibles and co-insurance percentages that got higher each change, from having unlimited therapy visits to having only 20 visits per year to split between all three therapies.  Twenty visits didn't even cover a full summer worth of therapies for Ann one summer with the recommendation of speech therapy twice a week and PT & OT once a week.  Because of the cost of therapies and the lack of coverage from insurance, Ann’s therapies are basically limited to what the school will provide. She currently receives all three therapies at school, but only gets one of each per week. This is not nearly enough.

 

Ann's parents request each school year at Ann's annual IEP meeting that Ann receive an extended school year.  The public school paid the Special Learning Center in Jefferson City to continue therapies til the end of June.  The rest of the summer, Ann’s family has to pay for her therapies. While insurance covered some of it, Ann's parents still had to pay over $1000, for six weeks of therapy. This doesn’t include the cost of driving to Jefferson City twice a week.


Ann needs much more therapy than the school offers. Having legislation passed to cover these therapies would be life changing for Ann and for her family. Not only would her family be able to afford more therapies and receive the needed amount of therapies for Ann, but hopefully it would make it possible for private therapy clinics to open near Tuscumbia. For parents who both spend long hours working on a hog farm, local therapy options would be greatly appreciated!

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