Most of us need help paying for our children’s health-care needs. Public programs, health insurance, and private foundations can help cover some adaptive and assistive devices and technology, therapies, respite care, transportation, modifying your home, doctor visits, prescriptions, job training, and education.
Getting help from these programs and organizations will often, but not always, depend on your income. Many of them also have interest (or waiting) lists and it will take time for you to get the funding or benefits. However, some will approve your family quicker. It is definitely worth looking into – and maybe applying for – a number of programs that might be of help to your child and family. Visit our Financial Help page to find out more about these programs.
There are 2 main types of health coverage: private insurance that you or your employer can purchase and government programs. Keep in mind that health insurance itself and federal programs such as Medicaid and CHIP are different, though many parents might refer to them both as insurance. Visit our About Insurance and Health-Care Benefits Programs page to find out more.
Government health benefits and insurance programs might help your family get health coverage or insurance at little or no cost, or pay for care your other health insurance might not cover. Here is a list of programs that may help you. Visit our About Insurance and Health-Care Benefits Programs page to learn more.
Supplemental Security Income (SSI) is a federal program through the Social Security Administration that offers monthly cash assistance to help you pay for your child’s personal and medical needs. It is for things like food and shelter, medical and dental care not covered under health insurance, and personal needs like clothing. You must apply and be approved for SSI based on your family or your child’s income.
Social Security Disability Income (SSDI) gives monthly cash benefits to those workers – or children of workers – who have paid enough Social Security taxes to get disability earnings they can use when they are no longer able to work.
Medicaid is a government program that provides medical services for people who meet certain income or disability requirements. It covers medically necessary services such as: doctor visits (including preventative care), dental care, therapies (such as physical, occupational, or speech therapy), mental health, medical equipment and supplies, some prescriptions, transportation to doctor visits or to pick up medicine, and more.
There are a number of programs that fall under the Medicaid umbrella. Visit our Medicaid page to find out more about them.
To get Medicaid in Texas, a person must:
Visit the website for Children’s Medicaid and Children’s Health Insurance Program (CHIP) or Your Texas Benefits to learn more.
Waivers let states use Medicaid funds for long-term home and community-based services and supports for people with disabilities or special health-care needs and the elderly in order to help them live in the community. They are named “waivers” because certain Medicaid requirements are waived (meaning they don’t apply). For example, family income. All but 1 waiver is based on just the child’s income and certain licensing requirements for service providers.
We strongly suggest that you consider adding your child to the waiver interest list(s), which many parents call “waiting lists,” if you haven’t already done so. Even if you hope your child will never need those services, it is very important that they be added to the interest list for any program(s) that might meet their needs. You can always decline the services once your child moves to the top of the list. Visit our Waivers page to learn more.
Most Medicaid programs require that families have a very low income to be approved. However, Medicaid Buy-In programs use higher income requirements to help children and adults with disabilities or special health-care needs get Medicaid health-care coverage and benefits.
Medicaid Buy-In for Children allows families who meet income requirements to buy Medicaid coverage for children age 18 or younger with disabilities or special health-care needs.
Medicaid Buy-In allows adults age 19 and older who have disabilities or special health-care needs and earn a certain amount of income through a job to buy Medicaid coverage.
Does anyone in your family get Medicaid? Can anyone in your family get health insurance through work? If you answered “yes” to both of these questions, Medicaid might help pay for that private health insurance through the Health Insurance Premium Payment (HIPP) program. Visit our HIPP page to learn more.
Medicare is the federal health insurance program for people age 65 and older, and for people who have a disability or special health-care needs and have been receiving SSDI benefits. If your child has been receiving Social Security Disability Insurance (SSDI) benefits for 24 months, Medicare might be an option to help pay for medically necessary services, care, and equipment.
When you have a child with a disability or special health-care needs, finding low-cost and accessible transportation is challenging if you do not own a car – or your car cannot transport your child comfortably. If your child has Medicaid, there is a transportation program that will give you some of those rides at no cost to you. Visit our Transportation page to learn more about the Medicaid transportation benefit and some other choices you might have in your community – and how to use them.
You have the right to appeal (ask for a second opinion on) insurance and benefit denials on behalf of your child. You have this right if your child has health-care benefits through Medicaid, your work, or a private insurance policy. Visit our Appealing a Health Insurance Decision page to get tips and facts.
In certain cases, some of the expenses related to taking care of your child lower the amount that you have to pay in federal income taxes. These expenses might include: certain home modifications, certain medical expenses, lodging (if you have to travel away from your home to care for your child), travel expenses to and from the doctor, or the cost of hiring someone to look after your child so that you can go to work. Our Financial Help page can help you understand more about taxes.
Even with health insurance coverage, prescription costs can add up quickly. Here are some suggestions to help you manage those costs.
Our Financial Help page can give you more tips that can help your family.
Most of us need help paying for our children’s health-care needs. Public programs, health insurance, and private foundations can help cover some of the costs. Our Financial Concerns and [Grants and Other Funding Sources pages can help you find help.
Many federal and state benefit programs limit the amount of savings and property your child can have and still be approved to get benefits. See our Wills and Trusts page to see how to protect your child’s benefits – and still save money for their future.