Ensuring Special Needs are Met

When my daughter Ellie was born with Down syndrome and two heart defects, we were lost on where to start to get her insured. As any parent of a child with special needs knows all too well, dealing with insurance is frustrating. The rules are confusing and ever-changing making sorting through it all a full-time job. It’s one of the hardest parts about caring for a child with a disability.

When Ellie was born, she was facing a year of hospital stays. Figuring out how to pay her medical bills took some expert help.

Each week we receive at least one insurance denial letter for an appointment, equipment or therapy. Watching the stack of bills grow causes anxiety and has forced some parents I know to file for medical bankruptcy before their child even entered kindergarten.

Special Needs Insurance Tips

From learning the hard way that preapproval is not a guarantee to spending years unraveling a paperwork error for home delivery of feeding tube supplies, we have amassed a few helpful tips:

• Medicaid is a program that uses state and federal money to help pay for medically necessary services for low-income families. If your child has a primary insurance through your work or the marketplace, Medicaid will be your child’s secondary insurance.

• TEFRA (Tax Equity and Fiscal Responsibility Act) is a Medicaid program that can help families with children under 19 who have a disability by paying the cost of services. For some, the program is free while others pay a premium on a sliding scale dependent on income.

• Apply for Medicaid and TEFRA through your local Department of Health Services office online.

• ARHIPP (Arkansas Health Insurance Premium Payment) is sponsored by Arkansas DHS and is designed to save money for Medicaid recipients with high health care costs. This program eliminates some out-of-pocket medical expenses by reimbursing all or a portion of the premium cost for your entire family’s primary health insurance. Apply at MyARHIPP.com.

• Forms AR1000RC5 and AR1000DC offer $500 tax credits. Find them at the Department of Finance and Administration’s website. One of the forms requires a doctor’s signature, so give yourself enough time before you file your taxes.

• Talking to other parents of kids with special needs, the financial office at your local hospital or doctor’s office, DHS or joining an online group like Medicaid Saves Lives (Arkansas) on Facebook can help you stay on top of the latest information.

Originally published in the August 2020 issue of Little Rock Family.

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