Sunday, October 18, 2009

Using your Medicaid card

When your child receives a waiver in the state of Ohio, they qualify for a Medicaid card. The Medicaid card can be an amazing tool for your child, not to mention it can save you a TON of money! Let's face it...autism is expensive...and a Medicaid card can help in many ways. The only downside is it doesn't come with any instructions or a "Where to use your Medicaid card" booklet. I have learned many uses for the Medicaid card over the last year, and I share them with you here:

1. The card can be used at any medical establishment that accepts Medicaid - Children's Hospital & Close to Home locations, possibly even your pediatrician's office. It can be used secondary to your primary insurance, and it will pay any co-pays and any balances your insurance does not cover (at least in my experience). This means every trip to the hospital, every blood draw...you won't have any balance due out-of-pocket.

2. The card can be used at a local pharmacy to pay for prescriptions. The prescription coverage is excellent, at least in comparison to our primary prescription coverage. I use a compounding pharmacy out of Cleveland to fill many of the prescriptions prescribed by our DAN doctor. They bill Medicaid, which saves me over $600 every month with my boys. Our local Kroger pharmacy does the same, and between our primary insurance and Medicaid, we rarely ever have to pay a dime out-of-pocket for prescriptions.

3. Chances are when dealing with a child with autism, when your child turns 3 years old, they may not be potty trained yet. If this is the case, Medicaid will pay for pull-ups for your child once they turn 3. There are some "order from home" delivery services you can get the pull-ups through that bill Medicaid. I am very happy with the name brand pull-ups, so I chose to have our pediatrician write a prescription and I have it filled at our local pharmacy. I am able to pick up enough day and night diapers to last an entire month at no cost.

4. Your Medicaid card can provide home health hours for your child. There are many home health agencies in Central Ohio that accept Medicaid. Many of these agencies will even hire your providers that might already be working with your child or that you hire to do so. Your child is entitled to a minimum of 14 hours per week, and in some cases your pediatrician will write a prescription for additional hours. Most agencies pay the aides $8-$10 per hour, so it is significantly less than waiver rates. But many families find ways to utilize these hours for respite time or self help skills. Home health hours can be a great resource.

5. Most importantly, the Medicaid card can provide your child with the therapies they absolutely need. With a prescription from your doctor, Medicaid will provide speech therapy and/or occupational therapy and/or physical therapy. Children can receive each of these therapies totally funded by Medicaid anywhere from once a month to twice a week. There are not many Medicaid providers for therapies, so you want to get your child on any wait lists as soon as you are offered a Medicaid waiver, if not before. I'll be posting a blog soon with a list of all therapy providers I know of, and it will indicate which providers accept Medicaid.

6. The Medicaid card gets you some great discounts locally. The best one I know of is at COSI. Just by showing your Ohio Medicaid card, you can get a family access annual membership to COSI for just $25! That cost $88 without the Medicaid card, and my kids absolutely love COSI, so we get more than our money's worth from this membership.

This post may provide you with additional information about your child's Medicaid card, but it probably also raises many questions. Please ask them here so that others can benefit and learn at the same time.

11 comments:

Anonymous said...

Don't forget about the "fun" benefits like discounted COSI membership.

Sarah Smalley said...

Thanks for reminding me...what a great benefit that is! I'll add it to the list now!

Sean, Angie, Theah, and Emma said...

Hi GREAT! post. what is COSI, we just recieved our dd's card and you are right there is no how to guid.
ABC pediatric therapy accepts medicaid and they have 2 S.OH locations

Sarah Smalley said...

COSI is a Center of Science and Industry in Columbus, Ohio. It was recently named America's #1 science center by Parents Magazine. You can check out their website at www.cosi.org. It's a lot of fun for kids, we try to go once a month.

Laura said...

How do they get the Medicaid card? Thru a Service Coordinator at Board of DD? Is it income-based?

Sarah Smalley said...

If your child receives a waiver from your county Board of MRDD, then they qualify for a Medicaid card, regardless of income. That is how every autism family who has a Medicaid card got theirs (that I know of). Of course, Medicaid can be awarded based on income, but the guidelines are incredibly low and it is very difficult to qualify. My sons both have level one waivers through Delaware County, but our county has a minimal waiting list and is very proactive in awarding waivers to children. In some counties the wait can be much much longer before the child gets a waiver, if ever. BE SURE to check with your child's county case supervisor as to where your child is on the wait list and ask if there is anything you can do to speed up the process!

Jen said...

is there an age requirement to get a medicaid card from mrdd? i called Franklin county MRDD them about my 19 month old son who needs speech therapy but they sai until 33 months all funding is through Help Me Grown, which we hae signe dupwith but there is a huge wait list. Thanks for your help. please also reply to jen.irwin@gmail.com

Anonymous said...

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Ohio Medicaid said...

I had no idea Medicaid could be awarded on the basis of specific medical needs. So glad to hear Medicaid is giving help to those who need it!

Lola said...

You can also apply for a Aged / Blind / Disabled Medicaid card at your local JFS office. Its still income based, but uses a spend down amount so your child can still get a card because they are disabled.

Anonymous said...

Does anyone know if insurance will pay for a special needs stroller? Or if your HSA would. My son is on the ASD. He can walk, but not for long periods of time and he is outgrowing his toddler stroller.