Therapeautic Foster Care Covered by State Children's Insurance!!

Discussion in 'General Parenting' started by susiestar, Apr 15, 2011.

  1. susiestar

    susiestar Roll With It

    We recently got health care coverage through our state dept of human services. I filled out the form to get coverage for the kids and was surprised when it also gave coverage for husband and I. Surprised and thrilled!

    We just got the handbook and as always I was reading through it.

    My jaw dropped when I read that Therapeautic Foster Care is covered with prior authorization!!!

    We don't need it and are not likely to need it with either Jess or thank you. It is nice to know it is there, esp because I never considered it as something health care might cover. After all, health care isn't covered and your eyes are part of your body, so why would foster care for a mentally/emotionally ill child be covered?

    I don't know how easy it is to access this benefit, but I am sure that if I needed to I could figure it out. I am sure it starts with the primary care doctor and most likely a psychiatrist and therapist too.

    I am mentioning this here because I know quite a few of us have children who are violent and it is not safe to have them living at home but there is no way to get them placed anywhere through a psychiatric hospital admit. I am very sure that MOST primary care docs, psychiatrists and tdocs are totally unaware of this also.

    I cannot remember the name, but I am esp thinking of the new member with a violent child and a easy child with a terminal illness and a 250 pound electric wheelchair. If I figure out which member it is I will PM her, but it might help even more people here.

    We are in OK and this is the Soonercare program, but it is our state's version of the various childrens health insurance plans that each state is required to have. I don't know if any private insurance plans cover this, but it cannot hurt to ask. If you have your state's children's insurance, you might call and ask if this is a benefit. I also STRONGLY recommend asking them to send you a handbook or comprehensive list of benefits. Often the phone reps only know the basics and are looking things up as you speak with them, so don't take what they say as gospel. You can also check online if your program has a website.

    If you don't qualify for this state insurance, check to see if there is a way to have your child qualify based on their diagnosis rather than your income. Some states also offer a way to qualify if your income is over the limit by having a "spend down" amount. This means that after you spend that amount of $$ on health care (including mental health and durable medical equipment) you will receive their plan's benefits. You do have to have any private insurance pay the bills first and the state plan will then pay all or part of the balance, depending on the plan and bill. Most of the time if you have private ins you won't qualify but some situations and/or medical problems are exceptions. If your company makes you pay extra for the children's coverage and your income is within the guidelines, or close, it may be wise to consider using the state plan instead of the private one. Not all people are told this - private co's want your business and the HR dept may not even know.