tefra (medicaid)Has anyone with a child with pdd-nos been able to get medicaid for your child under tefra or another program? Anyone tried but been denied coverage? If so, please tell me about the process. What were the requirements you had to fulfill to get the coverage? Did you have to go on a waiting list? Any info on this is appreciated. (I'm in the state of Virginia if it matters...) I'm in PA and I got Medicaid. I can't remember the whole process, but it was long and arduous. My mom did almost all of it. My doctors had to write letters and fill out forms and we had to submit my meager pay stubs. They determined that I was sufficiently disabled so as not to obtain health insurance through a job and approved me. I am under MAWD (Medical Assistance for Workers with Disabilities) so that I can make some money and maintain my benefits. Side note: I was not, however, determined to be disabled for SSI. They said "There is no reason Lydia can not obtain gainful employment." Right after Medicaid said I was disabled, too. I don't get it, and I'm frustrated at the inconsistency. Lydia, I agree with Trinity. Usually, one must apply two or three times to get what one needs. Sad, but true. Keep trying!Harriet We appealed and got a lawyer. But it's 18-22 months until they hear the case! We're about a year into that wait. Thanks for the encouragement!We didn't quality for Medicaid / Disability due to income, but once we were denied we applied for the Katie Beckett Waiver (GA) and received it within 2 months. The process for us was:
Lydia - definitely appeal. If you win, even if it is 2 years from now, you will get paid back from when you first applied, so that will be a nice check for you!! My son got Medicaid on the waiver. I had to submit all his doctors reports, etc. It took about 6 months. It was 4 years ago so I have to say I'm having a hard time remembering. I'll have to do a search for one of my old posts, as I'm sure I posted about it. I've heard a lot of people say that SSI almost always turns you down the first time and you have to appeal. In TX it almost "feels" like eligibility, especially under the waiver programs, is tied to a perceived ability to function. My little one will qualify for Medicaid through our state Medically Dependent Child Program (its a waiver like the Beckett). She has an autism diagnosis, though. My eldest, who has many more medical issues than his sister, did not qualify--even on appeal. He has an Asperger's diagnosis. Its insane.Phoenix - have you tried applying for SSI for your child? If you are eligible, you will automatically get medicaid.We were denied SSI de to income. That's why we had to go the waiver route.We are also currently going through the procees of applying for both SSI and Medicade for our son. We apparently have gone through the hearing stage and scheduled to see one of thier Dr.s next month. Hopefully we will hear more soon. We are into our 6th month now and they told me it should be 5 at the least - oh well !I was gonna say, the waiver program route is the best choice! We recieved Medicaid through SSI after a little over a year only to be turned down 6 months later cause my husband started to "make too much". Instead of fighting that losing battle, I decided to get my son's through a waiver program, have had no problems since. |
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