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What Does Medicaid Cover?
A MyAutismTeam Member asked a question 💭

Ok, so I heard that it covers pull ups, but does anyone know of other things/services it might cover?

posted August 29, 2013
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A MyAutismTeam Member

The waiver can also cover necessary items you may be unable to afford, like noise cancelling headphones, weighted blankets/vests, the Project Lifesaver bracelet and monthly fees for battery changes/service (if available in your area, you can check at www.projectlifesaver.org and search for your area), a safe area (think 8X10 with padded walls) that cannot go in any area used for everyday living (scratching my head on that one because we don't qualify unless I want to put it in the basement where it would be hard to use for the intended purpose). And my consumer choices option accountant says that Medicaid will pay for a tablet to be used for apps, not sure what it's called but I can ask her, we are not to the point where it would be practical to use a tablet, I tried but the screen was broken too many times for me to be able to afford the constant replacements so I am going to have to wait and reintroduce it later.
Where I live, there is a waitlist for waivers but the kids get right in, but that varies from state to state, like Jill-Longenecker stated above. Here in Iowa, you have to have applied for (not necessarily been approved for) SSI for your child and have proof you applied, and have an IQ test done, so if you intend to apply you may want to ask what you need to have done in the interim. When I applied I got a letter giving me 30 days to get IQ tests, and it was very hard to get it done in that time frame because most doctors here schedule 2 or 3 months out.

posted August 29, 2013
A MyAutismTeam Member

There's 3 types of Medicaid. The first type is traditional medicaid that is provided to people below a certain income level. The 2nd type of medicail is called Tefra and is provided to people with disabilities if they pass a certain type of criteria. Both of these types of Medicaid follow a medical model meaning it covers medical, dental, vision, and other traditional types of services. Diapers and pull-ups are covered if your child is pass the typical age of diapers and they are disabled. The catch is that you have to find a medicaid provider that covers these services.

The third type of Medicaid is a Medicaid waiver which is Nmaed differently in different states. The Medicaid waiver provides additional services such a respite, in-home supports, etc. The waiver is designed to keep severely disabled people in their communities instead of instititutions. So your child has to meet certain criteria. You have to apply separately for this funding. Most states have different rules and even when your child is approved, there's a waitlist.... because there's more people that need the services than funds.

posted August 29, 2013
A MyAutismTeam Member

Thank you soo much for your answers. I didnt know it covered so many expenses. My son has medicaid through the waiver.

posted August 29, 2013
A MyAutismTeam Member

We have state funded Medicaid because we are in MA and it is mandatory in this state to have insurance, but if you cannot afford to pay for your own they provide it.

My children also have SSI so we do not pay for my daughters pull ups or her vitamin supplement drinks they pay for it

posted August 29, 2013
A MyAutismTeam Member

There are services you can get there now you couldn't with regular Medicaid. Things like specialist visits without pre-authorization being necessary, OT (including physical fitness, sensory integration, feeding therapy...), PT, speech services, maybe even a behavior analyst if you can find one that accepts Medicaid (your waiver person can help you find one), which might be difficult depending on where you live. Medicaid will also pay for Behavioral Health Intervention Services (or B-HIS) in your home if it's needed, all you need for that is a dx of any mental health issue.

posted September 11, 2013

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