BENEFITS YOUR CHILD MAY QUALIFY FOR:
We as parents are our children's strongest advocates, so we have to make sure we are more than qualified for the job. A vital piece of that job is securing every single service and benefit that your child needs and/or qualifies to receive. Life is uncertain -- you just don't know what tomorrow will bring. As such, you want to make sure every single piece is set in place for your child to ensure they are covered and protected.
COMMONHEALTH (MA Health waiver program):
MA Health extends special benefits called Commonhealth to adults and children based on their disability, not family finances. This is coverage we strongly urge you to secure as it is critical backup health insurance to cover costly out-of –pocket expenses, and catastrophic health insurance coverage. Once you have your child covered under Commonhealth, they qualify for other extremely helpful benefits which include:
- diapers (for children who are not toilet trained by the age of 2 – CVS in Holden handles all the paperwork for this and are fabulous assistance/resource);
- Personal Care Attendant (full explanation provided below);
- communication devices;
- car seats and strollers for older children;
- full dental coverage (no cost share, no co-pays, no maximum yearly amount -- note Boston Children's Hospital has a great dental clinic for special needs children);
- unlimited OT, ST and PT;
- transportation to medical appointments and therapies;
- co-pays and Rxs;
- special diets.
Here is the link to the MA Health benefits application. This needs to be completed:
Along with this application, it is advisable to complete and attach this disability information application also so there is a short turnaround in getting a determination:
Please attach to this section all of your child's medical records that pertain to his disability. You must also complete a medical release:
Complete all documents, attach your child's medical records and get it out in the mail with cover letter that states you are applying for Commonhealth (<----- this has to be done or unfortunately your application can be mistakenly processed as a MA standard application which you do not qualify for. If this happens then all it takes is a phone call to correct). You should receive a decision within 3-4 weeks. Once they have accepted your child you will receive a bill for monthly premiums. Don't fret about that as the premium may seem steep. You must immediately contact the Premium Assistance number at 1-800-862-4840 (http://massfamilyvoices.org/publications/MSCPA.pdf link to more info on it).
What this benefit does is reimburse you for whatever monthly costs you have for private health insurance through your employer. So if you are paying $400/month for BC/BS family coverage, they will reimburse you that amount, less the MA Health premium they expect you to pay to
maintain coverage for your child. Usually you have no out of pockets to obtain this coverage.
Now your child has access to a wide range of MA Health benefits, such as a Personal Care Attendant (PCA).
Link to PCA application:
A PCA representative will come to your house with a nurse to ask you questions and meet your child. Based on the information they obtain, your child will be allotted a certain amount of time each week where you can hire assistance to help you care for your child. That assistance can come from anyone you chose who is 14 yrs old or older. The only person you cannot hire is your spouse. The amount of time they allot you is based on his/her needs when compared to a typical child his/her age. Be brutally honest with the PCA representative, this is not the time to brag about fleeting accomplishments. They are there to help you secure assistance, so an honest representation on what level of functioning your child is capable of performing independently for daily living skills is important.
Department of Developmental Services info:
DDS offers a wide range of benefits over the course of your child's lifetime. Benefits are based on funding, so every year there is uncertainty as to what your child will receive, but given the massive amount of out of pocket expenses we all have, every penny is helpful. Some benefits include flex funding, which is money allotted to your child every year (year runs July-June) that you can draw from to pay for activities such as gymnastics, swimming, etc. Tips -- keep your receipts for everything you purchase for your child and every activity they participate in. This will be helpful for both your taxes and DDS! DDS also allots respite hours which is a welcome benefit for any family. DDS provides free camps for children over school breaks and summers, free workshops, autism resource centers that are packed with resources, sibling social groups, and lots of great stuff that you can access once your child is accepted for benefits. It is much easier to call DDS on the phone and they will take info and have an intake person call you back to schedule a time to come to your house to meet your child and take an application from you. At the time of the visit it is imperative you have a copy of any and all medical records that deal with your child's disability copied for the DDS rep so that you can speed up a determination decision (which averages about a month or so). Once a determination is made you will receive a letter and be assigned a case manager. That case manager will meet with you and go over every benefit afforded to your child by DDS. They will also give you a lot of information about other state and federal benefits he/she may be eligible for. The two most important factors to remember with DDS is 1) make sure you give them ample records to make their determination with --- they review thousands of applications every year, you need to make your case for your child solid or he/she will be denied. 2) the squeaky wheel gets the grease. Call your case manager regularly. Out of sight is out of mind.