Kids and Insurance

 

Article by Heather Baird
Employee Benefits Account Manager
Insurance Trust

In the past few years, I’ve come to the epiphany of how important taking care of my mental health and wellbeing is in relation to my children and parenting. As a working parent, I’ve many times been overwhelmed with guilt. As a result, I’ve overcompensated with an abundance of love and attention, many times to the detriment of my own wellbeing.

Within our crew of buckaroos, we have various diagnoses including sensory processing disorder, ADHD, and anxiety. The past two years have been a whirlwind of assessments and specialist visits. Through the guidance of a wonderful team of specialists, aka “Team Baird”, and the support and advice of other moms, I’ve learned so much not only about each of these conditions and my kids, but about myself.

Dealing with the above in itself is overwhelming, but then add in the stress and complexity of paying for all of this, and it can feel insurmountable. If you know your child is going to need services in a coming year, you’ll want to review your plan options (multiple employer plans and/or a spouse or partner’s plans). Some things you’ll want to consider are out-of-pocket (OOP) maximums, specialist copayments, specialist visit limits, and HSA compatibility.

When reviewing your plan options instead of looking at a plan’s deductible you need to look at your maximum exposure, or maximum OOP limits. In most cases, an expensive procedure or a treatment plan with multiple specialists will result in you meeting a plan’s OOP maximum. This will be vital in planning and budgeting.

You’ll also want to see if the plan(s) offers copayments for specialist visits or if the costs go fully towards deductible and coinsurance. Keep in mind, copayments DO NOT go towards your deductible.

If you have a child who needs multiple therapy services (speech and occupational therapy), there is usually a limit per year. You’ll need to work with your providers to coordinate benefits, so you don’t exceed the maximum each year. In our case, we alternated specialists every other week. Most plans do not have a mental health maximum.

You will also want to review HSA options. Look at employer HSA contributions and the maximum family contribution limit versus the plan’s OOP maximums. HSAs are a way to save and budget for services with tax savings.

Finally, check with your employer regarding your Employee Assistance Programs (EAP) for 24/7 support, advice, and resources. Remember, each family is different, so what works for mine may not be the best plan for you. Talk to your HR director or employee benefits’ educator. We are resources to help you find the best benefits to match your family’s needs.

I want to end with a word of encouragement. Personally, I’ve blamed and shamed myself over my children’s diagnoses and struggles. Am I a perfect parent? Absolutely not! But that doesn’t mean this is my fault. I’ve had to come to a place of acceptance in my life that this is just what it is, and in that there is a freedom to move forward, learn, grow, and share what I’ve been given. We can’t always control our circumstances, but we do have a choice about how we react to them.

“The most profound personal growth does not happen while reading a book or meditating on a mat. It happens in the throes of conflict- when you are angry, afraid, frustrated. It happens when you are doing the same old thing and you suddenly realize that you have a choice.” ~Vironika Tugaleva

Below are several resources that have helped in our journey.