Please help! We need to get our daughter evaluated, but have no health insurance

[emma1325]

I'm planning to make my 7 year old daughter an appointment with a pediatrician soon to ask about how we should go about getting my daughter a psychological evaluation without medical insurance. She has had problems ever since her 5 month vaccine reaction...and it's only getting worse lately.  She has violent fits, irrational thoughts, mood problems and sensory issues.  Her problems seem to come and go...cycle in and out.

Tonight she had a 45 minute tantrum, with me and her father in the room. She was completely out of control.  We think she may be suffering from bipolar disorder.

This has been very difficult.  Please advise me on where to go with these problems without insurance or a ton of money to spend on expensive tests/treatment.  Are there any options available to uninsured parents of special needs children?

Thank you for any advice you can offer.

[khaoskat]

No clue, but when my son had some similar issues, we found out his behaviors were based upon sleep deprivation from sleep apnea.  My other son is having some similar issues, again we hope it is sleep deprivation due to (this time) RLS.

Does she qualify for the State insurance?  If so, often times you can have it done with a "pending state insurance" with  no cost to you.

[spedteacher30]

Since she is 7, the school system in your county/city/town must provide an evaluation at their expense--even if she is homeschooled or in private school. If you don't qualify for state health insurance, contact your school system's central office to request testing.

[emma1325]

Thanks...I don't know if she qualifies or not.  We don't qualify for any kind of medicaid because we make too much money.  We have some money to spend on an evaluation if the prices don't get outrageous.  We're even willing to sign up for an insurance plan if that would be better, but we're not really into going overboard with testing and treatment...we'd only be interested in those things which we deem absolutely necessary to get her better.  Don't know if that makes sense or not...my brain feels fried after hearing my daughter scream at the top of her lungs for almost an hour.  :(

Basically, we're medical minimalists...we don't want to waste money on things we feel are unnecessary, invasive or risky.  And I think sometimes having insurance can make doctors feel like you have to max out your options.  We want her to get better, but not by putting her through unnecessary risky tests such as cat scans and such.

[emma1325]

Originally Posted by spedteacher30 

Since she is 7, the school system in your county/city/town must provide an evaluation at their expense--even if she is homeschooled or in private school. If you don't qualify for state health insurance, contact your school system's central office to request testing.

[emma1325]

The school said they only evaluate for learning disorders.

[LauraLoo]

While you are figuring out a way to get your dd evaluated, consider picking up this book:

http://www.amazon.com/Explosive-Child-Understanding-Frustrated-Chronically/dp/0061906190/ref=sr_1_1?ie=UTF8&qid=1292043844&sr=8-1

Maybe there is something in here that can help you in the meantime.

[KCMichigan]

Originally Posted by emma1325 

The school said they only evaluate for learning disorders.

I would check on the website www.writghtslaw.com and read more about evaluation.  School do evaluate for emotional/behavioral disorders as well as learning disabilities and other Special needs. They have to provide for any Special Need that would impact a childs education.They can have a social worker and/or school psychologist evaluate her. They *may* request additional information from a medical dr, but they CAN do observations and suggestions. They schools may also have access to some resources you may not know of.

Most likely evaluation for Bipolar would involve checklists, observations, and possibly a neurology exam. It would not be terrible physically invasive, but emotionally may be stressful---but really could be helpful in the long term in how to deal with her behavior.

Good Luck! If you DO have insurance, some insurances do have coverage for evaluation at a reduced fee (ours is we pay 20%) for behavioral health (versus just academic testing).

[RiverTam]

Your department of public health should be able to direct you to the resources that you need:

[phone]

Bureau of Children’s Health – TX Dept. of Health

[Peony]

We've done several evals with DD1 for similar behavior. It is a little different for us because we have insurance but they cover nothing, and we always make slightly above income guidelines to qualify for anything despite living in a COL where that money doesn't go that far.  Some places we went to had sliding scale fees, others didn't, you either paid the full price or went else where. The school districts here also would not test a child for such things, they would refer you elsewhere. 

The health dept suggestion was a good idea, they should be able to point you in the direction of programs that can help you navigate the system. More then likely you need a referral from the pedi, or at least that it how it works at the health dept I work at. Another place we got referral to was to local mental health center. DD1 was 6 at the time, it was quite unsettling to get buzzed into a locked unit with my newborn to do intake appointments, but they had sliding scale fees. We only worked with staff that specialized in peds, while we ended up going a different route when she got better (help was critical then because she was talking about self injuring, was not sleeping at all, etc.. once she improved some and was stable we switched therapies). 

[girlzmommy00]

There are other options but they are income based.  My youngest dd had a psychological eval this past summer.  Our health insurance only covered part of it.  We had it done at a children's hospital which has an assistance program to pick up costs but it is income based.  Some hospitals offer that & will pay a percentage based on your income.  So if you have a much lower income, the hospital may pay 100% but if you make a little more, the hospital may pay 50% and you would pay the other 50%.  That might be something to look into. 

I live in New Jersey, it's a busy, suburban area but it was hard to find places that did psychological evaluations for children.  That's how I ended up at the children's hospital.  We have good insurance, it wasn't even about ins, just not many places do that kind of eval in general. 

But to be honest, if your daughter does have something going on, you may want to look into health insurance.  When you mention bipolar, that gets into medications, some are quite expensive or even if she only needed a weekly therapy of some sort for another condition (could be more than once a week depending on the diagnosis), that would pick up some or all of the costs. 

Good luck.

[anj_rn]

Contact your local branch of MHMRA.  They offer psych services on a sliding fee schedule based on income.  If you prefer, you may also contact a Federally Qualified Health center, they are required to offer medical & mental health services on a sliding fee scale as well.  They will also be willing to set up a payment plan.  For FQHCs in Texas, you can look at www.tachc.org.  I have also worked in this area for the last 6 years so you can PM me and I can help you find a clinic.  Most FQHCs offer medical, dental, & mental health services.  Some even offer specialty care & pharmacy services.

[emma1325]

Thank you everyone.  I'll look into everything that was mentioned here.