July 9, 2011
Autism – Get Coverage for Your Medical Expenses
For families with no insurance, the prospect of paying for therapies, doctors, diagnostic testing, medications, and adaptive equipment looms like an insurmountable challenge. However, there is hope and help available to these families that can help take the burden off of excruciatingly high medical and therapeutic costs. Having a child diagnosed with autism makes for difficult adjustments in family plans and financial goals. For many families without major medical coverage, the first option is to apply for Social Security Disability benefits for their child. These benefits include access to federally funded medical programs like Medicaid.
This can make qualifying for disability benefits difficult. Often families must fight to prove adequate disability on behalf of the child. That can sometimes take months or years. For these children, professionals may often debate the validity of a spectrum diagnosis. These children are believed to be somewhere on the autism spectrum, although where in particular is unclear. For example, many children are diagnosed with Pervasive Developmental Delay – Not Otherwise Specified. While children with classic autism are easily recognized and diagnosed, and therefore are virtually considered disabled by default, other areas of the spectrum are not as clear cut. Unfortunately, getting approval for SSI benefits for a child with autism is not as straight forward as it may seem.
These systems can cost hundreds or thousands of dollars. Likewise, therapeutic tools such as weighted clothing and sun lamps for sensory issues are not covered by every healthcare insurance plan. These systems can cost hundreds or thousands of dollars. Children with autism are characteristically wanderers, requiring parents to invest in specially designed home security systems that warn them if their child opens a door or window during the night or while the parent isn’t looking. Adaptive toys, therapeutic equipment, and home safety devices are often not covered. Even those families who have health insurance often struggle with overwhelming costs not covered by medical insurance.
These policies and waivers are known under different names in each state. However, each program works virtually the same. A family applies for Medicaid for the child. If their income is too high and they are denied, filing a petition for a hearing under the state’s need-based program or statutes begins the process. In the meantime, these uninsured children must still undergo treatment and therapies for their autism spectrum symptoms and challenges. However, there are still options available. Virtually every state has a system in place to allow families to apply for Medicaid for their child based on need rather than income.
Rather than proving the child is disabled enough to warrant assistance, these waiver programs and regulations require only that the family demonstrate the child’s needs versus the family’s income. When a child’s medical care for their autism diagnosis exceeds certain limits compared to the family’s income, the income may be disregarded to allow the child to get Medicaid benefits regardless of parental income. These waivers can often make the difference in the quality of care a child receives. This option is often much quicker than applying for disability benefits and covers the child with the same medical benefits.
Sean L Johnson is a journalist for Health Insurance Buyer a referral service that connects consumers to the insurance carriers that can best fit their wants or special needs. Click on link to access your free quote for health insurance, even if diagnosed with pre-existing Autism
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