Knowing your child’s rights to medical supports under Medicaid is one thing. Securing the actual services needed is something else entirely. That’s where our thirteen years of experience advocating for Medicaid services for children with disabilities comes in.
Our first step is going to be learning as much as possible about your child and her or his disabilities. We will ask to review medical reports and therapy evaluations, including ones done through your school. Don’t worry if you don’t have copies of everything; we will tell you what we need to see so you can request the necessary items.
If your child is not currently enrolled in Medicaid, we will review your local state programs and regulations to see what they may qualify for. Too many parents have been told the family makes too much money to qualify for Medicaid, while not being informed about possible state “waiver” programs their child may qualify for based on their disability and own income and assets. In these cases we will research your state’s Medicaid waiver programs and regulations to see if you can make a case to obtain Medicaid coverage as a secondary insurance for your child.
Regardless of how a child (under the age of 21) is enrolled in Medicaid, and whatever limitations your state waiver program may (try to) impose, federal regulations give them full rights to the gamut of services authorized under EPSDT.
Once we are familiar with your child’s unique needs, we will work with you to develop a strategy for obtaining the necessary services and supports. If you need “letters of medical necessity” from your child’s doctors and therapists, we may suggest topics these items need to discuss, and even specific language that should be included.
Be prepared for an arduous process, not entirely unlike working with your local school officials. Even when you think you have an airtight case for your child’s services, your request can still be denied. You may hear “our state doesn’t cover that service/medication/therapy”, and find you know more about Medicaid coverage than the people whose job it is to administer these services. Appealing denials of coverage may seem daunting at first, but they are a necessary part of advocating for your child. We will help you be as prepared as possible every step of the way.
- (646) 580-6721 or (808) 635-1246
- Toll Free (888) 511-0220