What does “payor of last resort” mean?

You will hear the service coordinator refer to the Regional Center as the “payor of last resort.” This means they only fund services if there is no other entity (called a “generic resource”) responsible for funding them. The Regional Center will always require you to exhaust private and community resources prior to approving funding. For children with private medical insurance, the Regional Center will require that you exhaust the insurance benefit for a service or receive a written denial before it will approve funding.

What constitutes a denial for Regional Center purposes? Here's one example: Kaiser doesn’t cover incontinence supplies, so Regional Center could take that as a denial. If your health plan does provide coverage but is denying your claim, Regional Center might encourage you to go through the insurance appeal process before agreeing to fund it.

For more information about what to expect from Regional Center services, check out our article Regional Center Eligibility and Services: Early Intervention (0–36 months) or Regional Center 101.