Tuesday, September 21, 2010

some tips and tidbits

All of the programs discussed below are programs in Texas. However, there may be similar programs in your area.

Its seems that when Ive gotten the medical community down and all figured out. I figure out that I really dont know a thing!!

So here's some things Ive recently come across, or maybe not so recently.


1. Medicaid can and will pay for diapers, pull ups, wipes at the age of 3

I was told that they wouldnt for about 6 months. Absolutely no doubt, no way. It starts at age 4. Which is when the medical community considers "typical" children to be potty trained.

Well after some frustration with buying 2 KIDS diapers. (once Milo was born) I pushed a little more. Lo and Behold there is a form that your nurse/doctor can fill out. and SHOULD fill out for you. It is called a letter of necessity. So for 6 months I paid for all of Toby's diapers when I shouldnt have because Medicaid would have covered it. My nurse just didnt want the word to get out and have to do lots of forms!!

The lessons I learned from this : Don't be afraid to push, reword the same question, ask lots of people the same question.

2. The medicaid waiver (at least in Texas) is not just a regular medicaid program. ITS SOOO MUCH BETTER!! I was pretty content with medicaid because it pays for our basic needs for Toby's medical care. I figured we stay on it with SSI as long as possible. but then I started finding out details of the waiver. The give you an extra yearly allowance to pay for extra medical supplies, therapies and things like that. So lets say Medicaid says, "naaaaa your kid doesnt need a new wheelchair, walker, bla bla bla." The medicaid waiver program says, "no problem!!" Then they also pay for improvements for your home to make it accessible for your child. AWESOME!!

The lessons I learned from this: Dont think you know a program. Dont think you know what program is best. Find out, ask, call and push. ask parents of children with special needs they seem to always know best.

3. Medicaid will pay the premium for your WHOLE family for insurance!! In texas its called Get Hipp. All you do is show that your employer is taking out insurance from your paycheck and medicaid pays it back to you!! CRAZY I KNOW!!


The lessons I learned from this: There are some amazing programs out there!! AMAZING!!

4. Medicaid has a gas reimbursment fund. Every therapy appointment, dr, dentist appointment medicaid will pay you to take your child. This might sound ridiculous. This might sound like you are using the system. But WAIT!! I have been told that this program NEEDS to be used. The program will cease to exist for families who need it if we dont start using it. The money that isnt used the program just loses.

The lessons I learned from this: Yes I can technically afford to take Toby to all his appointments, but it is one less burden we carry. Isnt it hard enough to make all of them as it is!? And dont you always ended up eating out or drinking more coffee or going out and buying a special toy because of a rough appointment. I feel more at ease doing these things now that i know gas is totally covered.

So I hope this helps. I hope this gives you some information. I hope that if anything at all it perks up your ears and gets you googling programs in your state or country. There are amazing things out there that should be used and arent being used.

Good luck!!
Kari

6 comments:

Amory said...

Kari,
This was such a helpful msg!
Would you mind if we chatted over email or something sometime about this stuff more indepth?
Thanks!

Kari said...

not a problem or fb chat? whatever is easiest for you!

Colleen said...

I love our medicaid waiver, but I am positive it does not pay for premiums and gas in Kentucky. It seems like waivers in TX are harder to get but they are about as good as they get.
I know a lot of people feel like they are accepting a hand out to use a waiver, but the way it was explained to me is that it just puts people with special needs on an even financial playing field with people who don't have special needs. We have so many copays, spend so much gas to and from appointments, spend so much on continence supplies and medications, and that's not even to mention the fact that it's hard to find "regular" daycare that can really accommodate our children. This just gives us an even playing field so we aren't sinking. I'm not a bit ashamed of accepting it.

laura said...

Thank you so much for this post! It helped:)

Adrienne, Scott, Hanna and Hayden Trigg said...

I can't believe about HIPP! Your post may be saving us hundreds of dollars a month! You have no idea how helpful this is to us here in Austin! THANK YOU!!!

Gretchen said...

Ummm... I think I need to move to Texas!!! I have asked and aksed about Meidcal waivers here, and keep being told this state dosen't have them! And I am seriously drowning with all of the expenses.... 15 doctor's and therapy appointments last week alone! Drowning.....

So glad other families are getting much needed assisance for their special kids :)