Florida Healthy Kids review: Healthy kids does not cover aba for special needs children after age 4.

I have a newly turned 5-year-old diagnosed with moderate-severe Autism. He was receiving ABA therapy (Applied Behavior Analysis), Speech Therapy and Occupational Therapy under Staywell’s MediKids insurance plan (in which we have always paid the highest premium under that plan) until October 2021 when we lost his Speech and Occupational Therapy due to the change from Staywell to Sunshine Health. Sunshine Health contracts with ATA and their rates are significantly lower (approx. $50hr lower than Medicaid rates) so the company he received therapy from decided to only accept CMS (Children’s Medical Services) clients because those are the rates that they have been used to receiving which are significantly more than ATA rates. We qualify for the special needs part of CMS but due to our income, we do not qualify for CMS. Our income comes from owning a company that provides therapy to children and adults with special needs and developmental disabilities, like my son. So, because of our total income being over $35,000 a year, my own son is not eligible for the same services that thousands under $35,000 per year can receive. I have been paying the full premium each month in addition to paying out of pocket for Speech and Occupational therapy. My son’s insurance changed to Healthy Kids on May 1, 2022 and now he is NO longer eligible for ABA therapy because Healthy Kids does NOT support ABA therapy for families like us, under their plans. This is total discrimination against special needs kids with families earning an income over $35,000. All of these therapies are crucial for my son’s development so I am forced to pay out of pocket for all three now. I wish someone could please help families like ours receive the therapeutic services that are medically necessary to help our children reach their fullest potential. On a side note, $35,000 per year for a two person family means that each parent can not make more than $8.75 per hour working a full time job, before the removal of taxes.