Do you know what YOUR insurance covers?

If you are reading this blog my guess is you either have a child with special needs OR you have a family member or friend with special needs.  Or maybe you just know someone with special needs.

Let me preface this by saying Elijah has MULTIPLE insurance companies.  Medicaid is NOT his primary insurance.  He has Anthem/Blue Cross/Blue Shield, Medicaid, and then BCMH (Bureau for Children with Medical Handicaps).

Elijah started getting his diapers paid for by Ohio Medicaid when he turned 3 years old.  I received the first shipment of 200 diapers just a few days after his birthday, actually.  I KNEW from friends that it was possible, and when I asked his doctor the month before his birthday, they started the paperwork process so that he would start receiving them right around his birthday.  Now that he is older, and has a substantial need for extra diapers, we now get 300.  There is not much that parents themselves have to do.  I actually was told by his pediatrician that all I had to do was talk to the pharmacy to get the order changed, and they did it all for me!  I picked up 6 cases of diapers the same day!  Also, I had asked if it was possible to get gloves and underpads for Elijah since we will be having others in our house to care for him.  He is MRSA positive and I would like to keep it contained! :) The pharmacy sent the request to the doctor, and I picked up 150 underpads, and 200 gloves with the 6 cases of diapers that day!

Fast forward three years and we are now beginning respite services (the same thing I do for my job, only the person/s come to our house and "relieve" me for X amount of hours).  We have multiple programs here that he is a part of.  The Level 1 waiver, which gives around 7-8 hours a week of a provider (depending on how you use the services, there are different things it can be used for!), the Core program which gives him 14 hours of a provider (thankfully, I have a great friend that works for the company that provides these services, and will be his provider!!), and the Individual Options waiver.  Mind you, these are only the services that I KNOW of.  He was on the waiting list for the Level 1 waiver for YEARS.  I mean, like 3 years.  I found out that the Core Program is a Medicaid program, and doesn't use his waiver money.  He is still on the IO waiver list but we are nearing the top of the list for that.  It pays out a LOT more than the Level 1 waiver so we are hoping to get to the top soon.  You would be so surprised how many people turn these waivers down when they get to the top!!!!

Please...if you do not know about these services...CALL your childs SSA or Caseworker.  Help is available...sometimes you just have to search for it!  Of course, this is just Ohio's information.  I have not bought diapers for Elijah since he was 3.  That is a GREAT thing in itself!  If you have a child with special needs or know someone who does...check into this info!

At the very least, if you have questions, please contact me.  I would gladly help you out!

~E.