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RE: What is Medwaiver?

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I called to get on the list, and they told me you have to wait till your child turns three. Then once on the list, you wait for years from everything I've heard. But they have a cap of 14K that you can spend on therapy, etc. Maybe someone else that has specifics can chime in and be more specific on what you can spend it on. I'd say it's definitly worth trying to get on the list as from what I understand there isn't an income cap, it's based on diagnoses.

Connie

What is Medwaiver?

Hi all,My name is & my wife is Sharon. We live in City. our son is 28 months old PDD-NOS. Can someone tell me what is Medwaiver?Thanks,

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I'm not sure if this question was fully answered. Medwaiver is a program for which your child will be eligible once he turns 3 years old. However, you must have a diagnosis of autism, not PDD-NOS. Bottom line, it's the same thing. If your child has PDD, he has autism, and you should not have a problem getting this "official" diagnosis. Then you get on the wait list (there were 15,000 on the wait list, 6,000 are getting called this year). Once your child gets to the top of the list, you will receive two types of services: Medicaid, which will cover medical, dental, pharmacy, therapies including speech, OT and PT; and waiver services, which will cover in-home supports like companions, Personal Care Assistants, babysitting in the form of respite, behavioral services. Other services which used to be included, and I'm not sure if they're being included any more for our kids with autism as opposed to adults or kids with other diagnoses, are transportation and housekeeping. I'm sure I'm leaving some stuff out, but you get the general drift. When your child does turn 3, I would register with APD (Agency for Persons with Disabilities ) immediately.

-----Original Message-----From: sList [mailto:sList ]On Behalf Of jsdw100Sent: Sunday, July 31, 2005 8:33 AMTo: sList Subject: What is Medwaiver?

Hi all,My name is & my wife is Sharon. We live in City. our son is 28 months old PDD-NOS. Can someone tell me what is Medwaiver?Thanks,

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Can you continue using your regular insurance after you the medicaid approved?

I have heard some horrow stories about not being allowed to see providers outside of medicaid list.

Sorry to keep asking on the same topic.

-Sandhya Karp wrote:

I'm not sure if this question was fully answered. Medwaiver is a program for which your child will be eligible once he turns 3 years old. However, you must have a diagnosis of autism, not PDD-NOS. Bottom line, it's the same thing. If your child has PDD, he has autism, and you should not have a problem getting this "official" diagnosis. Then you get on the wait list (there were 15,000 on the wait list, 6,000 are getting called this year). Once your child gets to the top of the list, you will receive two types of services: Medicaid, which will cover medical, dental, pharmacy, therapies including speech, OT and PT; and waiver services, which will cover in-home supports like companions, Personal Care Assistants, babysitting in the form of respite, behavioral services. Other services which used to be included, and I'm not sure if they're being included any more for our

kids with autism as opposed to adults or kids with other diagnoses, are transportation and housekeeping. I'm sure I'm leaving some stuff out, but you get the general drift. When your child does turn 3, I would register with APD (Agency for Persons with Disabilities ) immediately.

-----Original Message-----From: sList [mailto:sList ]On Behalf Of jsdw100Sent: Sunday, July 31, 2005 8:33 AMTo: sList Subject: What is Medwaiver?

Hi all,My name is & my wife is Sharon. We live in City. our son is 28 months old PDD-NOS. Can someone tell me what is Medwaiver?Thanks,

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The short answer is yes, you can still use your regular insurance. However, Medicaid is the payer of last resort. This means that charges will first be submitted to your regular insurance, and whatever is not paid, will be submitted to Medicaid. This makes for a very long period of time for your provider to get paid, or for you to get reimbursed.

-----Original Message-----From: sList [mailto:sList ]On Behalf Of Sandhya ChandarlapatySent: Tuesday, August 02, 2005 9:39 AMTo: sList Subject: RE: What is Medwaiver?

Can you continue using your regular insurance after you the medicaid approved?

I have heard some horrow stories about not being allowed to see providers outside of medicaid list.

Sorry to keep asking on the same topic.

-Sandhya Karp wrote:

I'm not sure if this question was fully answered. Medwaiver is a program for which your child will be eligible once he turns 3 years old. However, you must have a diagnosis of autism, not PDD-NOS. Bottom line, it's the same thing. If your child has PDD, he has autism, and you should not have a problem getting this "official" diagnosis. Then you get on the wait list (there were 15,000 on the wait list, 6,000 are getting called this year). Once your child gets to the top of the list, you will receive two types of services: Medicaid, which will cover medical, dental, pharmacy, therapies including speech, OT and PT; and waiver services, which will cover in-home supports like companions, Personal Care Assistants, babysitting in the form of respite, behavioral services. Other services which used to be included, and I'm not sure if they're being included any more for our kids with autism as opposed to adults or kids with other diagnoses, are transportation and housekeeping. I'm sure I'm leaving some stuff out, but you get the general drift. When your child does turn 3, I would register with APD (Agency for Persons with Disabilities ) immediately.

-----Original Message-----From: sList [mailto:sList ]On Behalf Of jsdw100Sent: Sunday, July 31, 2005 8:33 AMTo: sList Subject: What is Medwaiver?

Hi all,My name is & my wife is Sharon. We live in City. our son is 28 months old PDD-NOS. Can someone tell me what is Medwaiver?Thanks,

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The diagnosis of “autism”

needs to be from a licensed psychologist.

Stella

Laurella (’s Mom)

What is

Medwaiver?

Hi all,

My name is & my wife is Sharon. We

live in City. our

son is 28 months old PDD-NOS.

Can someone tell me what is Medwaiver?

Thanks,

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The diagnosis of “autism”

needs to be from a licensed psychologist.

Stella

Laurella (’s Mom)

What is

Medwaiver?

Hi all,

My name is & my wife is Sharon. We

live in City. our

son is 28 months old PDD-NOS.

Can someone tell me what is Medwaiver?

Thanks,

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In my son's case, Medicaid is secondary insurance to our primary

insurance. If primary denies a service, like ongoing therapies, then

Medicaid picks them up. But sometimes it can be messy, paperwork-wise,

for providers to deal with both insurances.

> Can you continue using your regular insurance after you the medicaid

approved?

> I have heard some horrow stories about not being allowed to see

providers outside of medicaid list.

> Sorry to keep asking on the same topic.

> -Sandhya

>

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