Why Medical Assistance for Children with Disabilities?
Pennsylvania is one of the only states in the nation that offers special health insurance to children with disabilities. This insurance is made possible through Medical Assistance (MA).
If you are the parent or guardian of a child or children with learning, physical or mental health disabilities, it can be both personally and financially overwhelming to find the means in which to provide for the medical bills or necessities required for their care. Medical Assistance can offer children who are considered disabled by the state, health insurance, regardless of the family income. This is eligibility guideline is called the “loophole”.
A child with a disability may have MA and private insurance such as a parent’s or guardian’s insurance obtained through their workplace. Should your child already have health insurance, Medical Assistance will act as a secondary plan without affecting the primary insurance benefits. And should a family not have insurance or lose its insurance coverage, their eligible child would still maintain insurance coverage under the MA.
What Parents need to know about Medical Assistance for Children with Disabilities
- Participation is voluntary
- There is no cost to the family MA
- The child’s Medical Necessity or DIAGNOSIS, not the family income, determines the child’s eligibility
- Why is this insurance available in Pennsylvania?
The State developed this insurance in 1992 because:
- Regular insurance plans have limits or ceiling; this one does not.
- Having medical expenses covered makes it easier for families to make important decisions regarding the healthcare for their children with disabilities.
- Eligible children will have health care coverage even if their family does not.
Some of the ways eligible children may benefit from this insurance:
- Coverage for co-pays for office visits,prescriptions and specialists
- Reimbursement for diapers with a Rx after the child turns 3 years of age
- Help with paying for glasses, hearing aids, assistive devices, dental
- Other services that may not be covered by private insurance plans.
This information is provided to help you learn more about the benefits that may be available to an eligible child. The Bucks County Intermediate Unit is a DPW Community Partner organization and we can assist you with obtaining, completing and submitting your Medical Assistance application. For more information, you are encouraged to contact Diane Sheehan at 800-770-4822 extension 1293 or email: firstname.lastname@example.org