Wednesday, January 11, 2012

Autism - What to Do If You Have No Insurance

Having a child diagnosed with autism makes for difficult adjustments in family plans and financial goals. For families with no insurance, the prospect of paying for therapies, doctors, diagnostic testing, medications, and adaptive equipment looms like an insurmountable challenge. However, there is hope and help available to these families that can help take the burden off of excruciatingly high medical and therapeutic costs. For many families without major medical coverage, the first option is to apply for Social Security Disability benefits for their child. These benefits include access to federally funded medical programs like Medicaid.

Unfortunately, getting approval for SSI benefits for a child with autism is not as straight forward as it may seem. While children with classic autism are easily recognized and diagnosed, and therefore are virtually considered disabled by default, other areas of the spectrum are not as clear cut. For example, many children are diagnosed with Pervasive Developmental Delay - Not Otherwise Specified. These children are believed to be somewhere on the autism spectrum, although where in particular is unclear. For these children, professionals may often debate the validity of a spectrum diagnosis. This can make qualifying for disability benefits difficult. Often families must fight to prove adequate disability on behalf of the child. That can sometimes take months or years.

In the meantime, these uninsured children must still undergo treatment and therapies for their autism spectrum symptoms and challenges. However, there are still options available. Virtually every state has a system in place to allow families to apply for Medicaid for their child based on need rather than income. These policies and waivers are known under different names in each state. However, each program works virtually the same. A family applies for Medicaid for the child. If their income is too high and they are denied, filing a petition for a hearing under the state's need-based program or statutes begins the process.

Rather than proving the child is disabled enough to warrant assistance, these waiver programs and regulations require only that the family demonstrate the child's needs versus the family's income. When a child's medical care for their autism diagnosis exceeds certain limits compared to the family's income, the income may be disregarded to allow the child to get Medicaid benefits regardless of parental income. These waivers can often make the difference in the quality of care a child receives. This option is often much quicker than applying for disability benefits and covers the child with the same medical benefits.

Sean L Johnson is a journalist for Health Insurance Buyer a referral service that refers consumers to the insurance carriers that can best fit their wants and needs. Get a free reduce quote today at

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