Please keep in mind that availability of financial resources is greatly dependent on your child’s diagnosis and, in some cases, family income.
Medicaid Waiver Programs
These types of programs are called “waivers” because they waive certain Medicaid requirements. This means that even if your child does not normally qualify for traditional Medicaid, it may still be possible to qualify for the Medicaid waiver programs.
The waiver programs offer services such as behavioral support, respite care, occupational therapy, physical therapy, speech therapy, minor home modifications, pre-vocational training, supported employment, transition assistance, prescription medications, residential services, day habilitation, and more. These waivers provide coverage for services that traditional insurances typically do not cover. Most waivers also provide Medicaid funding to children with disabilities regardless of family income.
CALL NOW to get on the interest lists, as some of the lists can be as long as 12-14 years. Although it may be hard to tell at this point in time what your child may need in the future, you can always decline services later if you feel that this assistance is no longer needed.
Please see below the list of waivers which are most often applicable to our patient population. When you call, you will need to provide your child’s social security number, Medicaid insurance number (if applicable), and basic information regarding your child’s diagnosis.
To be placed on the interest list for the waivers below, please call 1-877-438-5658. Tell the operator “I am calling to register my child on the waiver interest list for…”
- CLASS (Community Living Assistance Support Services) - for individuals with an intellectual disability, or related medical condition, that originated before age 22 and that affects a person’s ability to function in daily life.
- MCDP (Medically Dependent Children’s Program) - for children and young adults who are medically dependent.
There are other interest lists your child may qualify for as well; however, you must call your Local Intellectual and Developmental Disability Authority (LIDDA) to be placed on the additional interest lists below. Locate your county LIDDA below to obtain the phone number to call.
- Harris County: The Harris Center - 713-970-7799
- Fort Bend County: Texana Center - 281-239-1363
- Brazoria County: Gulf Coast Center (Select IDD services and intake) - 800-643-0967
- Liberty, Montgomery, & Walker Counties: Tri-County Services - 936-521-6100
- All other counties call 512-794-9268 to find your LIDDA or search online here
Call the LIDDA for your county and tell the operator “I am calling to register my child on the following waiver interest lists…”
- HCS (Home and Community based Services) - for persons with intellectual disabilities who are living with their family, in their own home, or in other community settings, such as small group homes.
- TxHml (Texas Home Living) - This program provides selected essential services and supports to people with intellectual and developmental disabilities who live with their families or in their own homes.
- YES Waiver (Youth Empowerment Services) - Provides community based services and supports for families caring for children with a serious emotional disturbance.
Medicaid Buy-In for Children
Medicaid Buy-In for Children is a program that allows families to buy Medicaid coverage for children age 18 or younger with disabilities or special healthcare needs.
If your income is over the limit for Medicaid or CHIP, you may still qualify for this program. If you are approved for this program, you will pay a monthly premium to Medicaid and your child will receive all the benefits of traditional Medicaid, including no co-pays for doctor visits. The premium is based on the amount of money your family makes and the number of people living in your home.
To apply for Medicaid Buy-In you must first apply for Medicaid. Once your receive the denial letter for Medicaid, call the number on the letter and tell them that you are interested in applying for the Medicaid Buy-In program.
For more information about this program, please visit Navigate Life Texas
Medicaid and the Children’s Health Insurance Program (CHIP)
Medicaid and the Children’s Health Insurance Program (CHIP) are state and federally funded programs that provide medical coverage for families in need. A family’s eligibility for either program is greatly dependent on their income and number of people within their home. While your child does not have to have a disability to qualify for Medicaid or CHIP, your family does have to meet the financial eligibility criteria.
CHIP and Children’s Medicaid both cover services such as:
- Dentist visits
- Eye exams and glasses
- Medical visits
- Prescription medications
- Hospital care and emergency services
- Diagnostic testing and lab work
- Treatment of special health needs and/or preexisting conditions
If your family qualifies for Medicaid, there is no cost for the above mentioned services. However, if your family qualifies for CHIP, you will pay a small enrollment fee of $50 or less and then co-pays for services will be assessed based on the family income. Co-pays typically range anywhere from $3-$35.
For more information regarding Medicaid or the Children’s Health Insurance Program (CHIP), please visit here.
Supplemental Security Income (SSI)
Supplemental Security Income (SSI) for children with disabilities is a federal program that offers monthly cash assistance to help caregivers cover the expenses of their children’s personal and medical needs. In order to qualify for SSI, your child must meet the Social Security Administration’s disability criteria and income guidelines. Children who qualify to receive SSI benefits will also qualify to receive STAR Kids Medicaid coverage.
If you would like more information on signing up for SSI you can obtain a SSI Child Disability Starter Kit (for children under 18) find out more here.
Interested parties can also visit the Navigate Life Texas to obtain more information regarding SSI and the eligibility criteria for children with special healthcare needs.