Most children with disabilities are eligible for Medical Assistance regardless of their parents' income. At least for now, the Department of Welfare (DPW) has chosen not to count any of the parents' income. The DPW will look at the income in the child's name or for money in certain trust funds. Once this card is obtained, it may be presented to cover medical bills that insurance does not pay, or if parents do not possess their own insurance of their own. The card will cover everything from routine office visits to prescription drugs to speech and language therapy. However, it is the parent's responsibility to determine if their pediatrician and local hospitals will accept this card as payment in full. Children's Hospital is a participating hospital for the MA card.
Definition of a Disability
- He or she has a medically determinable physical or mental impairment (or combination thereof);
- The impairment has lasted or is expected to last for at least one year or to result in death;
- The limitations caused by the impairment substantially reduce the child's ability to do the things and behave in the ways that children of a similar age normally do.
Steps to obtain the card:
1. Call or visit your local "County Assistance Office." The phone number will be in the blue pages of your phone book under "Government Offices--State", "Public Welfare Department of (Name of your County) County Assistance Office." Ask for the application PA 600 C "ACCESS to Medical Assistance for Children, Pregnant Women, and Their Families."
2. Complete the form as if the only person in your household who is applying is the child. Under a new state law, income of parent(s) must be listed, despite the fact that it is NOT considered when making a determination of the eligibility of the child (provided the child meets the disability requirements). Income of stepparents need not be reported. However, if your child receives income, such as Social Security Income, list that information.
3. To avoid a caseworker rejecting your application for failing to list income, write on the front of the application (at the top): "MA FOR DISABLED CHILD HANDBOOK SECTION 355.4"
4. Apply for social security income {SSI}. In some counties caseworkers are insisting that parents apply for SSI for the child and get rejected before they will authorize Medical Assistance. They may require you to present a rejection letter. You can apply over the phone, and it only takes about twenty minutes. The toll free number is 1-800-772-1213. Tell the caseworker that you are trying to acquire a medical card for your child who has a disability, you need a rejection letter sent to your home if you don't qualify.
5. Once you have the letter and your application is completed, call your local County Assistance Office again. Be sure to ask what items, in addition to the above, you need to bring.
6. Bring a copy of the child's medical diagnosis to the intake interview. This will enable the caseworker to issue you a temporary card and refer your case for further study. The card may be used immediately, but is only temporary, pending authorization. This will involve a study of your child's disability. Should your child be turned down for the permanent card, you will not have to pay back any monies used {as long as you were honest in reporting facts regarding the disability.
7. A representative will call you in approximately two months and will ask your to mail or bring in proof of the disability. It will then take about 4-5 more weeks for the permanent card to be issued. NOTE: Any phone or address changes should be reported at once to your Case Manager.
Proof of the Disability
Once the temporary medical card is issued, it is wise for the parents to begin building a case for proving the disability. Information needed for this purpose includes: diagnoses report from the doctor, psychologist, osteopath, or optometrist; school records, including test scores, notes from teachers, IEP's; Letters from therapists.
The information should include problems your child has with motor difficulties, social development, personal/behavior development, concentration, cognition, and communication. It is also recommended that the parents organize a cover letter stating what he/she feels makes his/her child different from his/her peers. Also note any personal information not included in the above, such as eating, sleeping, play habits, etc., that might be helpful in proving the disability.
If you have questions or simply want someone to talk you through this, please call ABOARD at (412) 781-4116.