Affording The Best Care Possible

by Brandi Savitt – July 26th, 2012

The Squeaky Wheel Gets the Oil

Last week, I had a doctor’s appointment with a specialist who was out of my insurance network.  She was revered as one of the top doctors – and one of the few true specialists – in her field.  And while I certainly didn’t want to pay for the visit upfront, I decided that seeking her opinion was worth it to me.

As we were talking she acknowledged that her office did not accept my insurance plan.  And then she said something that I didn’t even know was possible…  She suggested that if I wanted her to be my doctor, I should write a letter to my insurance company requesting that they make an exception and allow her to see me in network based on her specialty.  Interesting!  While I don’t think that most insurance companies like to openly bend the rules, I suspect if I make a strong enough case, they may just throw me a bone…

Getting the Care You Deserve

Whether it’s getting the best care for a medical issue or a child with special needs, many times people settle for the most obvious option because it is convenient – and they think that they can’t afford anything better.  But when it comes to the health and well being of our families, fighting to make the best choice for you more affordable, is not only worth it – it’s essential.

Challenge the System!

When our good friends Johanna and Steve were told their eighteen month old son had a severe learning disability and developmental delays, they found the best early intervention program in the city for his issue and enrolled him immediately.   The problem was, this highly specialized preschool cost $30,000 per year!  Their public school system also offered a decent - but in no way equivalent – intervention program – for free…

Johanna and Steve were not eligible for financial aid, but they were also not financially prepared to spend $30,000 year for preschool.  However, Johanna was unwilling to compromise her son’s care and education.  She knew in her heart that the private school was the best place for him.  There was no other option in her mind, and she was willing to fight for it.

After a lot of investigation, Johanna found out that she could actually petition her local school district and present her case as to why it was crucial her son stay in the private program, and how it would actually save the district money in the long run.  After several months and a lot of hard work, Johanna won her case, and the family was awarded funding by the district to help pay for the private school tuition.  And although Johanna and Steve were still responsible for paying about a fifth of the yearly tuition, the public school district paid the rest until their son transitioned (very successfully) into public school in first grade.

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3 Responses to “Affording The Best Care Possible”

  1. Betty says:

    What a helpful and informative article. Thank you!!

  2. Simone says:

    Great article. Thanks!

  3. louie says:

    The idea of requesting or petitioning for “care” out of the traditional box is a reasonable and prudent way to go. The example given of how “costs can be saved in the long run”, is something that all insurance companies and institutions want to evaluate and always give you the right to petition them for. Those that can present a comprehensive and legitimate case will be heard.

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