"But after years spent immersed in the science of touch, I can tell you that they are far more profound than we usually realize: They are our primary language of compassion and a primary means for spreading compassion."
Dacher Keltner, Greater Good magazine, University of California Berkeley
The Importance of Touch
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The skin is our body's largest organ. With our joints, hands, and skin, we use our sense of touch to gather information about our internal and external environments, making it crucially important for sensory perception. The ability to touch helps connect people as well. Affectionate and positive touch is associated with enhanced learning, language processing, improved problem solving, and even physical growth. Information from our sense of touch enters the nervous system from every part of the body. Conditions like Arthritis or Sensory Processing Disorder (SPD) can hinder this sense.
An Introduction to Sensory Processing Disorder (SPD)
Sensory Processing Disorder (SPD) is a disorder that impairs the processing of sensory information in the brain. For children, it can be a hindrance to motor skills like movement. It also allows for those who have the condition to feel bombarded by sensory information, including touch. The condition has not been properly diagnosed because until recently, there had not been a real biological explanation for the disorder. Luckily, there have been many advances and clinical trials that allow healthcare professionals to treat SPD better. The most common treatment is occupational therapy.
An Introduction to Arthritis
Another complication that can affect your sense of touch is known as Arthritis. Arthritis is swelling and tenderness of one or more joints. There are different types of Arthritis such as Osteoarthritis and Rheumatoid Arthritis. Osteoarthritis causes cartilage in between your bones and joints to break down, and Rheumatoid Arthritis is a disease in which the immune system attacks the joints themselves. All types of Arthritis mainly affect the spine, hands, and knees. This can cause painful movement during tactile functions.
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Medications for Arthritis are usually covered, however, you will still have to pay copays. Medicare will not cover over-the-counter medications that your doctor may recommend to managing Arthritis symptoms, such as Tylenol. Either way, those with Arthritis will still have to expect out-of-pocket expenses, which include premiums and copays.
Occupational vs Physical Therapy
Occupational therapy refers to therapy focusing on activities of daily living. It is different from physical therapy, which focuses on improving movement. For those with SPD, or Arthritis, occupational therapy is usually the most common treatment. By seeing a physical or occupational therapist, they can provide adequate treatment for those who have a touch sensitivity that hinders their everyday lives. For a lot of people, that therapy is necessary to go to work, school, or just live life.
Receiving Coverage for Occupational and Physical Therapy
Does health insurance cover occupational therapy? Most health plans do cover it, but only under strict guidelines. Insurance companies usually require a physician's referral to access coverage. In addition, your occupational therapy needs to be 'medically necessary' for it to be covered.
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What does 'medically necessary' entail? For the insurance company Aetna, this means that it must treat a specific condition, but only if that condition can improve. It's not medically necessary for members whose condition is neither regressing nor improving. So that means for those with a long-term or permanent sensory impairment, treatment is not covered. This is a similar policy to another insurance company called Humana.
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Even if your health plan covers occupational or physical therapy, you are still stuck with copayment costs, as with other healthcare services. Government-based insurance plans like Medicaid vary in coverage for occupational or physical therapy on a state-by-state basis.
The Bottom Line
Insurance companies who create guidelines for coverage of certain necessary medications and therapies should not limit coverage to those who only need temporary benefits. You should not be punished financially because of a condition or sensory impairment (such as SPD) that you cannot control.