Military insurance may extend autism coverage

by Daniela Altimari -

As an infant, Cody Kapacziewski hit all his developmental milestones except those relating to language.

“He didn’t babble much,” recalled his mother, Kimberly Kapacziewski. “He was walking on time, standing on time, but the language was never there.”

Cody was diagnosed with autism at 20 months and soon after, his parents started him in an intensive and expensive therapy program called applied behavioral analysis, or ABA. Cody, now 3, responds to his name and has made many other strides.

Yet he is only receiving 12 hours of ABA therapy a week, not the 25 hours a week that his developmental pediatrician recommends. That’s because Tricare, the military insurance provider that the family relies on, does not cover any more than that.

Cody’s father, Army Ranger and Connecticut native Joe Kapacziewski, has been deployed 11 times since he joined the Army on Sept. 13, 2011. After his right leg was shattered by an enemy grenade in 2005, he chose to have it amputated to improve his mobility and remain a Ranger. (He is due back at Fort Benning, Georgia, this week from his latest deployment in Afghanistan.)

The Kapacziewskis and other military families whose children have autism are pressing for Congress to require Tricare to expand coverage for ABA.

They have found an outspoken ally in U.S. Rep. John Larson. The Democrat, who represents Connecticut’s 1st District, is a member of a congressional caucus on autism and he first learned about the military coverage gap from a group of constituents.

“To find out that your own government is denying this … it’s just insane,” Larson said. “You could have taken my jaw off the floor.”

Larson, along with Republican Rep. Tom Rooney of Florida, included a provision in the defense authorization bill that increases coverage for ABA for autism. The measure also extends ABA coverage to those with other developmental disabilities such as Down syndrome, which are currently not eligible under Tricare.

The bill passed the House last month and Larson expressed hope it will make it into the final version of the Senate bill as well. In that chamber, it has the backing of key members from both sides of the aisle, including Sen. Patty Murray, D-Washington, and Sen. Marco Rubio, R-Florida.

“This is a rarity in Congress where you get bipartisan support and consensus,” Larson said. “I’m optimistic about its success.”

The transient nature of military life makes the benefit all the more necessary, advocates say.

Read more at Military Families Press For Increased Coverage Of Autism Treatment.

[Via Courant]

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