Can I Claim Little Gym Cost Through Insurance?

J.,

I can't say whether or not you can claim it through your private insurance but if your child qualifies for services through your regional center you may be able to get them to cover it. I don't know what they call it in your area but it is the public agency for children with disablilies under the age of 3. I am a Kindermusik teacher and a vendor for our County's regional center and they pay for some of my students classes. Children with downs syndrome, autism, motor delays, developmental disabliities have all qualified for services. Talk to your case worker and she may be able to guide you, it does need to be a program with clear developmental benefits. It also depends on how many services your child qualifies for. Feel free to email me privately if you would like to discuss it furthur.

Best of luck to you,
F.

If your insurance won't pay for it you might look into it being reimbursable through a pre-tax medical spending account... just a thought.

Dear J.,
If your in-home therapy is covered by your insurance, your therapist might be able to request insurance authorization to use the facilities at Little Gym as part of her work with your child and get some of the fees reimbursed that way.
You could contact Little Gym personally and ask them if they've ever dealt with insurance billing, etc. I could be wrong, but it's my guess they don't do that.
Physical/occupational therapy needs to be ordered by a physician and considered medically necessary for insurance to cover it. Then, there needs to be diagnostic codes and procedure codes provided with the claim forms. There's no way around that.
I'm an insurance agent and I've also been a patient.
I had to have 4 months of physical therapy after breaking my leg. Although they told me swimming would be good for me, the facility didn't provide a therapist who specifically did that, so if I chose to pay pool fees, those would have been paid fully by me. It would have been considered elective as opposed to medically necessary. My insurance would not have paid for it.
Talk to your therapist. Talk to your insurance company asking a hypothetical question. Then talk to the doctor about it. Those three entities need to be in agreement. Your insurance may cover outside therapy, but have a list of providers you need to choose from in order to have it covered.

I wish you the best!

I don't know if you can claim the cost of the program through insurance, but I thought I would let you know that we have had customers at Gymboree who have had their occupational therapist bring the child to Gymboree and do some of the motor therapy there. Because you can either follow what the group is doing at Gymboree or "do your own thing", it was pretty easy for the therapists to work on individual pieces with their clients in an environment that the child loved. One therapist told me she was happy the family had the child doing some therapy at Gymboree because there were no battles about doing it once he was at Gymboree. In other words, it was easier than doing it at home or at a park.

Good luck with whatever you decide to do.

J. F.

Have you seen First Toddle -- a play gym for the home that adjust to multiple heights and provides a stable, safe and encouraging environment to help all children who need a bit more support. Includes play and sports accessories that help with motor skills and cognitive development. Entertains a child from age 3 months to 3+ years and beyond. See www.FirstToddle.com for more information. Hope this helps.

Call your insurance company and ask them what documentation or proof you need to make that happen. I'm sure you'll have to have at least a dr's prescription, probably helpful to have your therapists write a note to tell them how it is beneficial and will save them $$ to do it. AND don't take no for an answer.

You should also be getting services from Early Start and they may pay for that instead of therapy.

Hello J.,
I haven't done this with a child's special needs but we did with my husband as part of his cancer treatments. We found that we had to have it written as a medical requirement, or perscription otherwise it wasn't accepted by the insurance or the IRS. You also might try talking to your OT about this.
Having 5 children and one with special needs it is understandable that you want to do everything possible for your little one. I wish you well, Nana Glenda

You need to speak with your insurance carrier. The type of play at the gym will enhance your childs abilities but are not specifically therapy in nature. I know my health insurance will not cover the cost of any gym program, regardless of age.