Medical Assistance

ATTENTION FAMILIES OF CHILDREN WITH SPECIAL NEEDS

This page is dedicated to informing families of children with special needs about Medical Assistance, a program in Pennsylvania that covers children’s medical needs, and also, to finding families who mistakenly believe that their children no longer qualify for Medical Assistance. It has come to our attention that the Pennsylvania Department of Public Welfare (DPW) sent many families a letter in 2012 indicating that new policies would require families to pay for Medical Assistance. Some of these families did not sign up for Medical Assistance the following year. It is vital that we communicate the following facts about Medical Assistance:

• Many families with children with special needs meet eligibility requirements for Medical Assistance regardless of family income. Children can receive all medically necessary services free of charge. Eligible diagnoses include autism, ADHD, Tourette’s syndrome, etc. Even families who have primary insurance can use Medical Assistance as the secondary insurer. Covered medical services include diagnostic assessments, prescription medications, psychiatric and psychological services, applied behavioral analysis, rehabilitative care, speech, occupational and physical therapy, radiology, lab work, etc. Expenses DO NOT have to relate to the diagnosis used to meet eligibility requirements. To find out about the program and whether your child is eligible, go to https://www.compass.state.pa.us/compass.web/CMHOM.aspx

• In 2012, the DPW sent a letter claiming that families with Medical Assistance would have to start paying copays for medical services, in many cases equal to or greater than the benefits those families received. As a result, some families did not sign up for Medical Assistance during the next yearly enrollment period. In reality, families with children who meet the definition of disability are still entitled to Medical Assistance, free of charge and without copays.

If you or someone you know did not sign up for Medical Assistance or discontinued their previous coverage based on the 2012 DPW letter, there might be help available. Please contact Marc Davies at Marc@yourchildsrights.com for information.