Why Medical Assistance (MA):

If you are the guardian of a child with a learning, physical, or mental health disability, it may be financially overwhelming to find the means to pay for medical bills or necessities. Medical Assistance is a health insurance program for children who are disabled or are from low-income families. Children who are considered disabled by the state can apply for medical assistance, regardless of family income through the "loophole".

A child with a disability may have MA and private insurance such as a parent/guardian's insurance obtained through their workplace. The MA will serve as a secondary insurance if the parent/guardian has private insurance. If MA is the child's only medical coverage, the family can use MA to pay for diapers (if the child is over six), the dentist, the eye doctor, prescriptions, related therapies, as well as public mental health services. There are no annual or lifetime caps that are often imposed by other insurance plans. It includes services that are rarely covered by employer provided insurance such as the following:

• Mental health wraparound services-certain wraparound services can only be obtained through Medical Assistance
• Family based services
• Shift nursing (8 hours or more per day)
• In-home personal care services
• Diapers
• Nutritional supplements
• Prescriptions
• Transportation to and from medical appointments
• Hearing aids
• In-home nursing
• Physical therapy
• Speech therapy
• Occupational therapy

Upon receiving official documentation of a disability, the process to apply for medical assistance begins. The process starts at your local assistance office. MA is available for any disabled child, despite the income of the guardian. However, if a child receives survival benefits they may not be eligible for the program.

Will my child qualify?

Children with disabilities may qualify for Medical Assistance, regardless of their parent's income. Here are some basic rules:

• A child can qualify for Medical Assistance even if they have other health insurance (private insurance is typically billed first)
• The income/assets of the parents/guardians does not count in determining eligibility for Medical Assistance if the child's condition meets certain disability standards. The income of the parents/guardians still must be verified.

1. Fill out the "Application for Health Care Coverage" - form PA600CH - it may be accessed online at www.compass.state.pa.us
2. Fill out the "Report of Physical/Mental Examination"- form PA586
3. Assemble the following documentation:
• Child's social security card (or a receipt that an application has been filed)
• Child's birth certificate (not a photocopy) or an equivalent alternative (passport, etc.)
• For non-citizens, proof of immigration status such as an alien registration card
• Proof of address (driver's license, utility bill, etc.)
• Front and back copy of any other health insurance for the child (Personal Choice, Delta Dental, Vision coverage, etc.)
• Verification of income the child receives in his/her name (child support, social security benefits, etc.), as well as, caregiver income information for the previous 30 days
• Recent medical information from a physician, which includes diagnosis, prognosis, treatment plan, and any medications. If your child is school age, a current IEP (Individualized Education Plan) is needed. An IEP alone is not sufficient. Any reports that list your child's diagnosis, symptoms and how these symptoms affect your child's daily life. How long these symptoms are expected to last, and how these symptoms limit your child's ability to function. Any reports from therapists and counselors documenting your child's limitations in motor skills, communication skills, concentration, task persistence, and personal and social skills

4. Consider hand-delivering the application (even those filled out on the computer) to one of the addresses below:

Bucks County Assistance Office

Bucks County Office Center

1214 New Rodgers Rd

Bristol, PA 19007-2593

215-781-3300 or toll free 1-800-362-1291

5. For assistance in completing the MA application you may call or visit the Free Clinic of Doylestown located on the first floor of the Doylestown Hospital.

Free Clinic of Doylestown-Doylestown Hospital

1-800-462-0819 Select option #2 and then ask to speak to someone about MA

Monday through Friday 9 am to 4 pm

For further assistance, you may call the Medical Assistance hotline 1-800-842-2020