Should I ask for Medical Assistance (in PA)

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Hi,

I live in Pennsylvania and I am filling out the CHIP application. They have a section where they ask if anyone has a chronic disability. I am trying to decide if I want to put down my daughter's aspergers in this section or just put the application through without it. I know if I put the aspergers down, it will come back with medical assistance instead of CHIP. I am afraid that I will have less doctors to pick from with Medical Assistance though I am not sure of that.

My daughters aspergers is mild and she does very well academically (is cyber schooled). We are also doing a long, intense biomedical program to help her with some physical as well as neurological stuff (OCD, sensory stuff).

Anybody have any experience with this and an idea of what would be the better way to go?

Thanks so much, Sandy

If you are filing for CHIP help, don't put down that there is anything wrong with your daughter or they will deny you. It's government funded you know

Because of the peculiarities of PA, I would ask this of a Pennsylvania organization - try the Pennsylvania Health Law Project http://www.phlp.org/ or the Disability Rights Network of PA http://www.drnpa.org/

Thanks! I talked with my husband and we decided not to put it down. I think that I may have more choices with CHIP than with medical assistance and I am not sure that I want to label her for insurance purposes.

Thanks, Sandy

FYI, if you ever wind up with private insurance, your child with Asperger's may qualify for MA in addition, as a "family of one," regardless of your income. Pennsylvania is a loophole state, in this regard, and it can be very useful to have the MA as a secondary insurance, in case you need services that are not covered by private insurance (whether because private insurance denies coverage due to diagnosis, which is supposed to end as of July 2009, thanks to Dennis O'Brian's work, or because it is a service not generally covered by private insurance, like wraparound services or sometimes OT, PT, speech & language therapy ...)

You should absolutely apply! It is not income based for a child with a disbility. We applied when our son was receiving feeding therapy at the Children's Institute, before he was even diagnosed. First you get an Access card and then in 30 days you are asked to chose an HMO>>>just make sure you research what each covers, authorizations, etc. The medicaid HMO picks up pediatrician copays that are not covered by our primary...prescriptions, OT etc. You have to apply for SSI first...if you are denied, you just need to ask for 'a formal denial letter' and then you can apply for Medicaid. Any ?????'s let me know if I can help!

Are social skills programs covered by Medicaid? I have been wondering this.

Sometimes. There are some providers who accept MA, some (more) who don't. Some accept MA after the primary insurer denies coverage (which most will).

Social skills are variously provided by OT's, SLP's, Social Workers, psychologists ... The type of provider can impact the likelihood of the service being covered by any insurance, MA or otherwise.