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Medi-Cal/private Insurance For Autism
A MyAutismTeam Member asked a question 💭

Yesterday our case manager at the San Andreas Regional Center and I discussing cost sharing for respite services, and she said that if my daughter qualified for Medi-Cal then SARC would cover 100% of the cost of respite care. She offered to refer her to Medi-Cal, saying that if we applied ourselves we could be denied based on income, but if she referred us, they would look at her application as being for someone with a disability and be more likely to approve it.

I have misgivings about it… read more

posted August 1, 2015
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A MyAutismTeam Member

take what they offer that probable a max amoun t - the you can switch and use your own insurance

take all you can get - services are hard to get and are very costly

posted August 2, 2015
A MyAutismTeam Member

My kids have had Medi-Cal based on the Regional Center waiver for many years (like almost 15 in one case.) As long as it's clear that the Medi-Cal is secondary, then there is no problem using our private insurance. None of my providers who do not take Medi-Cal has had any problem whatsoever billing me for the co-pay. I would ask your favorite provider whether this is an issue, just to be sure.

posted August 17, 2015
A MyAutismTeam Member

I discussed it with the insurance guru at my daughter's PT. it turns out that if I get her Medi-Cal, any provider that doesn't accept Medi-Cal gets the shaft. They can't get the copay from Medi-Cal (secondary), and they can't bill me for it, either. Some quirk of the law. Since they can't get paid, they can't treat Medi-Cal patients.

I have a great team of therapists and doctors for my daughter, and I don't think any of them accept Medi-Cal. If I got Medi-Cal for her, I'd have to build a new team from the ground up. We'd lose a lot of treatment time in the interim, the expertise in treating her that the therapists have developed over time, continuity, and I doubt I could find as good of a team again.

Medi-Cal isn't a good choice for her, at least for now.

posted August 6, 2015
A MyAutismTeam Member

Call Medi-Cal - (Phone number can only be seen by the question and answer creators) - and ask the question. We have it for our autistic grandson (we are guardians). I have found the coverage excellent to date. But we do not have private insurance (we are both on medi-care) so I can't address that part of your question.

posted August 6, 2015 (edited)

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