Special Needs

ASD and medicaid ?

DS is almost 2.5 and we received his diagnosis a month ago. We are in-between a rock and a hard place with getting his therapies covered after the age of 3. Right now through ChildFind (EI) we have a speech therapist once per week and an OT once per week. The school district has been incredibly difficult to work with and ultimately decide where DS will go to preschool. DS needs to be in a smaller classroom setting with about a 1:4 teacher child ratio. We just feel like he needs more than what the school district can offer which is a 1:15 ratio and not even a guarantee of additional help in the classroom. 

The school we want to send DS offers therapy at school, but its $160 per hour and is considered out of network for our insurance. I don't think we qualify for medicaid. But was wondering that if regardless of your income, did your child qualify for medicaid based on the ASD diagnosis?  

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Re: ASD and medicaid ?

  • You know I'm not sure but maybe.  My sister has gone through several different dxs and I'm pretty sure they still haven't gotten it right but she qualified for medicaid because her dx technically made her "handicapped" and even though she works and has insurance through her job, she still has medicaid, which helps greatly when it comes to her medication and gives us peace of mind in the event she were to lose her job.  

    Contact your local office and maybe even Social Security.  When we were kids, I seem to recall my mom used to get SSI for her.  Might help.

    Good luck. 

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  • Sorry - forgot to add that her school (through age 20!) and transportation were all paid by medicaid.
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  • The school district did evaluate him because that is who ChildFind operates with. Its relatively the same thing. We had him evaluated for a developmental and speech delay in Oct '11 and he qualified for a SLP once per week in our home.

    We went through Children's Hospital to get his ASD diagnosis. That is where the child psych and dev. pedi recommended a smaller classroom setting for DS. They don't want him to get lost in the system.

    Our caseworker from EI who works with the school district, told us we can only receive services for DS in the preschool classroom setting and are no longer eligible for in home services once DS turns 3.

    And we don't have a say in the school they place him. I was told that directly by the school district due to the fact he in the "special needs' category with an autism diagnosis.

    We have our hands tied and have been told that because the district funds services, they decide when and where he receives them. I have a few friends who have gone through this process with our school district and decided to move based on the districts unwillingness to work with parents. 

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