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Ruling extends therapy coverage to military retirees

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Posted: Wednesday, August 8, 2012 12:00 pm

By Rose L. Thayer

Fort Hood Herald

Military families with autism are celebrating a victory in the ongoing battle to get therapy covered for retirees.

Judge Reggie Walton of U.S. District Court for the District of Columbia, ruled Tricare must provide coverage of applied behavioral analysis therapy for family members of military retirees, just as it does for active-duty troops.

"It's a relief," said Suzie Svoboda, an Army spouse with an autistic son. She and her husband often talk about what it would take for 7-year-old Tyler to keep up his therapy once her husband retires from the Army.

"You have to plan for retirement in general, then to add on (Applied Behavior Analysis) treatment, it wouldn't be an option for a lot of families," said Svoboda, who recently moved from Fort Hood to Shaw Air Force Base. "ABA is something that's not done just for children — it's all different ages and young adults. It doesn't stop. It would have been a lot for us to have to worry about and all the other costs of what happens when he gets out."

Limited service now

As it stands now, Tricare offers a limited amount of ABA therapy under the Extended Health Care Option, a program only open to active-duty service members.

Even though 32 states now require insurance companies to provide coverage for the therapy, Tricare does not recognize it as a proven medical treatment, said Karen Driscoll, associate director for federal government affairs and military relations for the advocacy group Autism Speaks.

"I believe the writing is on the wall and I hope that Tricare will continue providing access to these treatments that we know work," she said.

It is unclear if Tricare plans to appeal the court's decision, and Tricare spokesperson Austin Camacho said the company does not comment on pending litigation.

Regardless, Driscoll said she sees the ruling as a huge milestone for families.

"Until we know the department's intent, we will continue the legislative effort," she said. "We will continue to work with our advocates in Congress to help ensure this decision is part of a sensible path forward to providing this treatment without delay."

Watching closely

Killeen resident Valerie Hughes has been watching the situation closely. Her husband, who served 21 years in the Army and four tours overseas, retired in February only to learn their autistic son's ABA therapy would not be covered.

"My son needs his ABA therapy," said Hughes of 11-year-old Wesley. "You not only get kicked out, but speech and (occupational therapy) have a copay."

Even though Wesley still struggles with verbal communication, he was forced to go from twice weekly therapy in each type to speech therapy once a week. To get ABA back would be a blessing, Hughes said.

"This is a lifelong benefit for the future of Wesley," she said. "I think we're going to watch this and keep it in prayers, because it would benefit so many children."

Contact Rose L. Thayer at rthayer@kdhnews.com or (254) 501-7463. Follow her on Twitter at KDHmilitary.

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