4 Tips for Funding Your Child's Medical and Therapeutic Needs
Feb. 9, 2022Updated Nov. 23, 2022
We know how hard it can be to figure out how to fund your child’s medical and therapeutic needs, but it doesn't have to be so time-consuming and stressful! For more insight on how to pay for everything, we met with Undivided’s Public Benefits Specialist, Lisa Concoff Kronbeck, and Director of Health Plan Advocacy, Leslie Lobel, who answered funding questions from our community of parents during a live event on February 3, 2022. Here are the top four things parents should know about paying for services and medical supplies.
Understand the paying "order of operations" for insurance and public benefits
Both Lisa and Leslie explained that there's an order in which organizations will pay for a service or claim. Private insurance is always first, and the next in line follows a general pattern, as explained by Leslie in this clip:
Use both insurance AND Medi-Cal if you can
You may be able to get a service like ABA therapy entirely covered by using your primary insurance first and then Medi-Cal to pay for the rest. It depends on what type of Medi-Cal coverage you have and whether the provider is contracted with Medi-Cal, and there are some exceptions, as Leslie explains in this clip:
Regional Center clients may also be able to get funding for therapeutic services. As Lisa W. wrote in the chat during our event, "I am getting copay assistance from Regional Center because the provider is not a Medi-Cal provider." Copays add up, so even getting that small amount of funding helps!
Get a doctor's prescription for medical supplies
One question that came up in the chat during our live event was how to get incontinence supplies like diapers covered. In this clip, Leslie and Lisa explain what should be in a prescription from your doctor in order to get your primary insurance and Medi-Cal to cover these supplies:
Parents in the Undivided community can confirm that this tip works! In the chat during our event, Andi M. wrote, "We got pull-ups through Medi-Cal with a doctor prescription." Undivided Navigator Iris Barker responded, "We did too, and it was so helpful for the time we used it!"
Don't give up after a denial of claims
If you have documentation showing that a service or item is medically necessary, you don't have to simply accept a denial. You have a right to appeal! Listen to the advice from Lisa and Leslie in this clip about how and why to appeal:
Undivided's experts gave plenty of other great advice during our live event. If you missed it or want to review what we learned, you can watch the full recording here, and check out our article How Do We Pay For It All? for even more information!
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