When you’re the primary caregiver for someone with disabilities, there is nothing more frustrating than being unable to get the services you know they need. For the parents of children with disabilities, this frustration is even greater. You want your child to reach his or her best potential, something that special education law doesn’t grant them.
Our job is to help you help your child. If your child is aged 20 or under and already signed up for Medicaid, we will work with you to access the full array of services they are entitled to under federal law.
For children not currently covered by Medicaid, we will see if there is a way to get them enrolled in one of your state’s special programs for people with disabilities. Called “waiver” programs, eligibility is determined by the child’s income and assets, not the family’s. In cases like these, Medicaid can even function as a secondary form of health insurance while still giving them full access to the benefits of federal law.
Knowing Your Child’s Legal Rights Under Medicaid
Children from birth through age 20 are covered under a subsection of federal Medicaid law called EPSDT – Early and Periodic Screening, Detection and Treatment. Under EPSDT, children have a legal right to every service a medical provider says is medically necessary, whether or not that service is offered to adults under your state Medicaid plan. The law specifically gives these children access to all the services and supports they need to reach their “best possible functional level.”
The economic supposition is that money spent now is less money spent in the future.
For example, EPSDT allows your child access to all the following services, equipment and supports (with a doctor’s prescription):
* The full range of therapies, including OT, PT, Speech, hippotherapy, water therapy and behavioral therapy, as much as 300 minutes per week each
* Medications, including over-the-counter ones, medical diets and nutritional supplements
* Non-durable medical supplies such as diapers, syringes (one per day of different sizes), catheters (as many as needed per day), catheter insertion trays, foley bags, g-tube buttons (one per month), venting supplies such as Farrell bags, g-tube extension tubing (one per day), etc.
* Durable medical equipment such as wheelchairs, shower chairs or bath benches, standing tables, adaptive mobility devices such as bikes and gait trainers, speech generating devices, pulse oximeters, suctioning machines, and oxygen equipment (including rentals of oxygen condensers for air travel)
* In-home services necessary to keep the child out of an institution, including up to to 24/7 skilled nursing, and personal care assistants
* Splints and orthotic devices
* Travel to and from local therapies
* Travel to out-of-state specialists for the child, a companion and a nurse if nursing is normally required), including flights, ground transportation at your destination, lodging and a food allowance
If your child is not currently receiving all the services and supports they need to remain at home, in their communities, while reaching their best possible functional level, we are here to help. You can either use our contact page, or use the contact information in the sidebar to the right. Visit our Services page to see how we work to help you help your child.
- (646) 580-6721 or (808) 635-1246
- Toll Free (888) 511-0220