Health Insurance for Babies with Down Syndrome

Today Ryan McCostlin, a team member at Bernard Health, is going to share the Top 5 Health Insurance Tips for new parents of babies with Down syndrome.

When new moms and dads have a beautiful new baby, the questions can seem endless. What are the right foods? ...the right child care? ...do I need to buy Kidz Bop records, or is it okay if I play The Rolling Stones?

And while learning how to be a new parent can be a heck of a lot of fun, finding the right health insurance strategy... well... isn’t. . I happen to be someone who spends most of his time thinking about health insurance, and even I can admit that on the fun spectrum, shopping for health insurance can fall somewhere between tax audits and root canals.

That said, all parents spend time thinking about how to plan for expected and unexpected medical expenses. And for parents of babies with Down syndrome, there can be additional costs associated with neurological exams, cardiology exams, thyroid screening, etc. So while finding the right health insurance strategy might not be very much fun, it is important.

So, what should new parents of a baby with Down syndrome know as they begin to research health insurance options? Here are the top 5 tips:

1. Depending on your income and your state’s rules, your child may qualify for a government subsidized health insurance program called Medicaid. The name for the program varies from state-to-state... for example, it’s called MediCal in California and TennCare in Tennessee, but each state’s program is a version of the federal Medicaid program. If your annual income is too high to qualify for Medicaid in your state, your child may qualify for another government program called CHIP. To research government subsidized options in your state, you can click here.

2. If you have group health insurance through an employer, most employers have a 30 day window from the birth of your child to add him/her to your plan as a dependent. If you choose to add your child to your employer’s health plan, make sure you share your good news with your HR representative so you can fill out the appropriate paperwork!

3. If you don’t have access to insurance through your employer and you don’t qualify for a government program, you can still get coverage for your child through an individual health insurance plan. Child-only plans aren’t available in every state, but because of healthcare reform, children cannot be denied coverage by health insurance companies as long as at least one eligible parent also applies.

4. Consider enrolling in a Health Savings Account based health insurance plan if your employer offers one... and especially if you’re enrolling in an individual plan for your family. At first glance, it may seem like a co-pay based health insurance plan is a better option, but Health Savings Account based plans often have a true annual out-of-pocket limit on spending. After you meet your deductible, your child’s healthcare is free for the rest of the year. Families with lots of healthcare expenses often find that Health Savings Account based plans can help them come out ahead

5. Health insurance can be complicated, and it’s especially important for new parents of Down syndrome babies to consider all of the available options. If you need more help, there are several resources available who can provide guidance. As you consider where to seek additional help for your family, know that there are three basic categories of advisors:

First, each state has a State Health Insurance Program (SHIP) that can answer basic questions about health insurance eligibility. Advice from SHIP employees is free, and you can find your state’s SHIP contact information online.

Second, you can find a health insurance salesman who may be able to help you research private health plans. Health insurance salesman don’t charge you anything up front, but they get paid when they sell you an insurance policy.

Finally, many families find it helpful to work with fee-based health insurance advisors who, for a flat fee, can help you navigate the complexities of the individual health insurance market. This option is similar to a tax advisor or CPA who helps you prepare your taxes. While the flat fees vary, health insurance advisors usually don’t work on commission, so their only incentive is to help you get the right strategy in place for your new child.

More about the author: Ryan joined Bernard Health in 2010 to help families save time, save money, and get peace of mind as they consider affordable health insurance options. Through a network of retail stores, Bernard’s team of licensed, non-commissioned health insurance advisors provide face-to-face advice to families across the country. He earned a BS from Vanderbilt and an MBA from Yale. Ryan can be found on LinkedIn and Twitter.

Book Review and Giveaway—"Meet Annie"

Lisa Morguess who blogs over at Life as I Know It also has another blog titled, Turn the Page where she exclusively writes book reviews. She is an excellent and fair reviewer so I was pleased that she agreed to write a review of Meet Annie by Heather J. Scharlau-Hollis.

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In this short and sweet book aimed at young children, we meet Annie who is just like you and me in all the ways that count to little kids: she likes to play with her toys, she likes to splash around in her swimming pool, and she sometimes gets in trouble. But Annie is also a little bit different - she has Down syndrome. Although the book doesn't explain what Down syndrome is, it touches on the fact that Annie looks a little bit different and learns a little bit differently, and that everyone is a little bit different in their own way, and those differences make us who we are. My favorite aspect of the book is how the author invites and encourages its audience to identity with Annie by asking a question at the end of each page:

"Sometimes my zipper doesn't zip right. I ask Dad for help. Do you ever need help?"

"Sometimes I cry when I get scared. Do you ever get scared?"

Encouraging empathy and compassion without resorting to condescension or stereotypes, this is a wonderful book that should have a place on everyone's bookshelf who is touched by a child with Down syndrome.

Giveaway
The author of Meet Annie, Heather J. Scharlau-Hollis, will send a signed copy of the book to one lucky winner. To enter the drawing simply leave a comment below by Wednesday April 18th. Good luck!

Hippotherapy—Just Horsin' Around?

Guest post by Alyson who blogs at wordsofhisheart. (Make sure you check out her blog. She has a wealth of great speech resources there.)

The first time I heard about hippotherapy, I didn't take it very seriously. I envisioned children who should have been in physical therapy instead donning cowboy hats and going for a leisurely trail ride.

But when Noah turned 5 and still wasn't speaking, I remembered posts I had seen on our local Down syndrome network from parents singing the praises of hippotherapy. After doing online research and watching some amazing YouTube videos of children participating in speech, occupational, and physical therapy while riding, it became clear that these therapies were successfully coordinated into the hippotherapy session, mimicking real life experiences.

Seeing the integration peaked my interest because Noah was having a difficult time processing the information necessary for speech along with all the other skills he was acquiring. When his speech therapist confirmed a diagnosis of apraxia, I knew it was time to pursue hippotherapy.

Was it grasping at straws? Maybe. But the amazing results we’ve seen in the four weeks Noah has been participating in hippotherapy have convinced me of its value as a legitimate therapeutic modality.



The Four Week Scoop
Week 1: An adult rode on the horse with Noah. They spent a few minutes in the arena walking and then throwing balls into a basketball hoop where Noah worked on color identification. Next they rode outside on the trail where the trees were full of hanging animals—a perfect opportunity to work on vocabulary and signing. I was worried that he would be terrified; he wasn't.

Week 2: Noah rode the horse by himself. His therapist and the arena volunteers walked along either side of the horse. During this session Noah's posture had improved. Instead of the common low tone slouch, Noah was sitting straight and tall. This was an instinctual posture correction that was necessary to feel the most secure on the horse. No prompting was necessary.

Week 3: Noah couldn't get on that horse fast enough. When his time on horseback ended, Noah’s PT had him do some running, throwing, and climbing using onsite equipment.

Week 4. Noah rode that horse backward! The PT actually had him sit facing the horse's tail for part of the session. He rode in from the trail in that position, and it was evident by his posture and expression that his confidence level was very high. After the ride, he continued his running, throwing, and climbing.

The Results
The biggest change for Noah has been the area of speech. Prior to hippotherapy, he could say only a few words clearly and would attempt speech only if it was modeled for him. After only four sessions, Noah speaks about 20 words clearly and is making approximations of several more, sometimes spontaneously. Something extraordinary happens to Noah when he is up on that horse and it carries over to his daily living. The feeling of the rhythm of the horse walking seems to be helping Noah’s brain organize what it needs to make speech happen.

Hippotherapy Vs. Horseback Riding
There is a notable difference between hippotherapy and horseback riding. In hippotherapy, the horse is used as the treatment tool to achieve physical, speech, and occupational therapy goals. In horseback riding, the rider's focus is to improve on their horsemanship skills, and in the process develop companionship, responsibility, confidence, and leadership skills.

Getting Started
So, you're interested in hippotherapy for your child... now what? If your child is at least 2 years old and currently receiving early intervention services, ask his or her therapists if they offer board-certified hippotherapy or if they know of a local therapist that does. I was not even aware Noah's center offered it until I asked. You can also visit the American Hippotherapy Association to find a therapist in your area. Remember, this is not just a physical therapy option; speech and occupational therapists can also be board certified to conduct hippotherapy sessions as well.

And now for the question everyone wants answered: Will insurance pay for it? Under some policies, yes insurance will pay for it. When submitting therapy claims, the insurance company is not usually interested in what equipment is used in therapy; they just want to know who provided the service and that the therapy did take place. Unless a policy specifically excludes equine-assisted (horse) therapy, they will likely cover it. Unfortunately, Medicaid is an insurer who specifically excludes hippotherapy. The good news is that many of the hippotherapy centers offer scholarships, so don't hesitate to ask if you need one.

Happy Trails!

Your Turn
I was so excited after reading Alyson’s post that I went straight to the AHA and located a few therapists in our area. We are going to pursue hippotherapy! How about you? Has your child participated in hippotherapy? If so, were you impressed with the results? If your child hasn’t done it yet, are you interested in checking out hippotherapy?

I'll be there...will you?

Guest post by Kelli

The National Down Syndrome Convention is fast approaching...July 16th-18th in Orlando, FL. I'll be there...will you?

Last year Monica over at Monkey Musings designed badges for all moms that attended and blog about their life with Down Syndrome so that everyone could be easily identified. This year, as she is expecting their 5th child (brave, brave woman)...she has passed the baton, to me! So, if you are attending and would like a badge, please let me know by commenting on this post or emailing me at livinglifewithes (at) yahoo (dot) com.

I hope many of you do attend...I cannot wait to meet you and shake your hand...oh, who am I kidding, I would love to give you a big fat hug... you have become an extention of my family through your encouragement and support. I can't wait to see your smiling faces in person and tell you how much I appreciate you sharing your lives through your blogs.

If you haven't registered yet..make sure you hurry over to the website and do it now, you have to register before June 10th to get the early bird rate (it sounds like I am talking about a meal, doesn't it!). If you haven't decided whether or not you are going...well consider that it's in ORLANDO where there is always an abundance of sunshine and fun, especially for the kiddos!

I would like to make sure that everyone that plans on attending gets a badge so if you woudn't mind helping me spread the word, I would really appreciate you linking back to this post from your blog or mentioning it in some way so that I can make sure that all DS bloggers receive a badge if they want one.

Hope to see you all in July!!!


(Note from ds.mama... Well, we were planning on going and then something big, something huge happened (I'll tell you about it later this week ;-) and we had to change our plans for this summer. We'll miss you guys and Mickey too.)

Shake Your Bootie

There’s no better way to celebrate a Buddy Walk than with a new pair of homemade sweater booties. Lianna over at My Life With Gabriel is giving away a free pair everyday this week in honor of Canadian Down syndrome awareness. All you have to do is visit her blog and leave her a comment to be entered in the daily drawing. Well, what are you waiting for... shake your bootie on over there!

Summer Giveaway

What would you say to a woman who has just found out she is carrying a baby with Down syndrome and is torn about what to do?

Answer this question by July 31 in the comments section of this post or in a post of your own and you will be entered into the DSNM summer giveaway. During the first week of August, I will post my answer to the question and link to all your posts. I will also list the random winner who will have the choice of either prize pack listed below.

The Child Pack
The child pack consists of a bottle of Nordic Naturals Children’s DHA, strawberry flavored, in liquid or soft gel form (your choice) along with the book, No No Yes Yes by Leslie Patricelli.

The Parent Pack
The parent pack consists of the book, More Than a Mom: Living a Full And Balanced Life When Your Child Has Special Needs by Amy Baskin and Heather Fawcett. (Ok, Dan, I hear you... if it were me I woulda named it More Than a Parent...) and a Lindt Classics Caramel Assortment box of candy. (Can you tell ds.mama likes to read and eat bon bons?)


The real prize is that the words you write may well be read by a mom who needs to hear the truth from a parent who knows what that is.

What If?

by guest blogger ch

Our daughter, LC, is adopted. My husband and I stood in the delivery room and watched her birth. We were left speechless by the honor of becoming her parents in a way that felt as if we had been tangibly touched by the hand of God.

(What if adoption didn’t ask a birth mother to say, "Take this from me" but, instead whispered, "Share this child with me"?)


The truth is, we adopted a baby that didn’t need a mom. LC has a mother. And, believe me, she has earned the title. When she learned of her unborn baby’s diagnosis of Down syndrome and multiple heart defects early in her pregnancy, she did her research and attended numerous appointments with a variety of specialists to ensure this child would have every possible chance at a healthy birth.

For over 200 mornings she was kicked awake by little feet that would one day run through someone else's home. Month after month, she saw doctors and endured procedures to care for a baby’s heart she would entrust to someone else's keeping. For so many weeks, she sacrificed relationships, social acceptance, and convenience to shelter a tiny body. Night after night, she prayed for her child, and for the strength she would need to say good bye.

(What if adoption wasn’t about breaking ties but about building teams?)

People immediately become uneasy when I acknowledge LC’s birth mother. They rush to assure me that I am LC's mom...as if the two were mutually exclusive. I am, indeed, LC's mom and quite proud to be so! I am equally honored to have been invited to assume that role by a woman whose humor, courage, and faith both humble and astound me.

Because of this woman’s choice, LC was blessed with life. She will never feel that she was baby with an undesirable diagnosis —abandoned and found by new parents. LC will know she was unceasingly loved by a multitude of people from the moment each one learned of her impending arrival. She will know that the love she deserves required more than a single person could provide. She will also know that love didn’t require a relationship to be broken, just expanded. We were chosen as a gift to LC by someone who loved her, and continues to do so.

(What if the arms reaching out to adopt a child ensured a bestowing mother would never have to let go?)

God didn’t bring LC to us. Instead, He brought us to LC’s mother. He didn’t send us because we were equipped with amazing faith or infallible parenting skills, nor because we needed a baby. He sent us because He had heard the sound of a mother’s heart breaking.

We didn’t go to create a new family, but to join an existing one. A baby was coming who would need the prayers and ferocious love of more than a few to bring her through the trials she would face in this world. Our reaching arms weren’t fixed to take away. God intended them to hold something together and LC’s mother was brave enough to open her own, and invite us in.

(What if adoption was less about abandonment and more about abundance?)

Our near-daily chats with LC’s mother don’t lessen LC’s recognition of my husband and I as her parents. The presence of a Kellymom in LC’s life does not rob me of my own Momma title. The acknowledgment of our shared parenting role doesn’t compromise the impact my husband and I have on LC’s life, or call into question to whom she belongs. LC belongs to a God who proves it every day through the miracles He works in and through her.

She has been entrusted to us for now and we have been called to continue a good work begun in her long before she reached our hearts or arms. She is both the result of a promise kept to us by God and a reminder of the promise we have vowed to keep.

Inside LC’s baby book, beside a picture of her mother, are lines from the poem, "A Valediction: Forbidding Mourning" by John Donne.

Our two souls therefore, which are one,
Though I must go, endure not yet
A breach, but an expansion,
Like gold to aery thinness beat.

(What if adoption was about creating a blended family to celebrate and share life?)

LC is not the claimed fragment of a mother’s broken heart tossed aside. She is the unifying rhythm of a group of people who have unexpectedly found themselves sharing a single heartbeat. We are a family made possible by a mother’s courageous faith and the grace of an infinitely loving God. We are a family held together by a love like spun gold, wrapping us up and increasing our value to more than we would have ever been alone. There is no question that agonizing sacrifices have been asked of each of us along the way, but also no doubt that they have added to the luster and shine of the treasure we now find ourselves sharing.

-- ch


How to Share the Love

If you are pregnant with a baby that has been diagnosed with Down syndrome and would like to know more about sharing this gift of a child with another family, please contact Adoption STAR. They can assist you with finding a waiting family with whom to share your precious child.