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AUTISM, CELEBRATED

In this month’s Story of Hope, Michelle Smith and her husband Brandon share the joys of parenting their nonverbal autistic son, Mason. Both Michelle and Brandon are proud parents and are hopeful for Mason’s future. Noted Brandon, “We are fortunate to have a son who is incredibly happy and a joy to us and his therapists.”

Mason was 17 months old when Michelle and Brandon first took him in for an assessment because he was developmentally behind in many areas. Seven months later Mason was diagnosed with ASD.

Communication continues to be the biggest challenge for Mason, who is currently receiving speech and ABA Therapy. To improve Mason’s insurance coverage a small change was made in their insurance policy verbiage. This change was misinterpreted and Mason’s coverage was dramatically reduced. Within 2-3 weeks of the change their insurance provider was no longer covering Mason’s OPT, PT, speech and ABA therapy. The family was not notified of the changes, and in fact had been assured by their insurance provider that Mason would continue to receive unlimited visits for these services until the age of 7. Due to the time-consuming claims process and the amount of services Mason was receiving, they quickly accrued roughly $3,000 in unpaid claims. Soon they were in danger of being dropped from multiple service providers.

The Smiths had to make a tough choice between going heavily in debt to keep Mason in these services or risk losing access to services for at least 6-12 months. At this difficult time Brandon felt, “We were between a rock and a hard place.”

Searching for a solution, the Smiths reached out to WAAA for assistance. With guidance from WAAA, Michelle and Brandon teamed up with insurance navigator Trish Thrush and pursued an arduous claim appeal against their insurance provider. They were successful in getting their denied claims paid and the insurance provider chalked the whole thing up to network wide processing error. Michelle asserts, “I can say with confidence that without WAAA in our corner, the insurance provider would have steam rolled us. WAAA turned their indifference into action.”

In the face of these challenges Brandon feels, “The challenges we have raising a child with ASD have made me much more empathetic, not only towards special needs families, but to people in general. Most of the time I am simply dealing with these challenges and don't think much of it. Then there are moments of clarity on the real daily challenges we face and an understanding that it’s going to be a life-long commitment.” Reflecting on life with Mason, Brandon explained, “Love, hope and faith are what I seem to be left with. Love for Mason. Hope that his life is lived to its fullest potential. Faith that while we are never in control, we are also never alone.”

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