Programs for Children and Adults with Disabilities and Special Health Care Needs

Part 4, Chapter 13: Specialized Situations: Programs for Children and Adults with Disabilities and Special Health Care Needs Page 1

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Children and adults with disabilities or special health care needs may sometimes find that they have difficulty in obtaining health insurance, or that their medical needs are not fully met by their existing individual or group health insurance policies. In such cases, coverage for medical treatment or durable medical equipment may be available through Medicaid, through other programs sponsored by state and federal agencies, or through alternate sources of funding.

Medicaid

Some children with disabilities and special health care needs may be eligible for health insurance coverage through Medicaid. Medicaid is a government-sponsored program designed to provide health insurance for eligible children with disabilities and for eligible individuals whose incomes fall below the poverty line. In the case of children with disabilities, eligibility is determined partly on the basis of family income.

Currently, Medicaid serves as an essential part of the American system of health insurance. However, it unfortunately appears to suffer from the same complex, fragmented, approach that seems to serve as the basis for the overall health insurance system in America. For example, Medicaid originated as a federal program and continues to be partially funded by the federal government. However, each state is given the authority to develop many of the rules under which the particular program will operate within that state. Thus, while federal regulations provide for a core of basic services in all states, including doctors' visits and hospital care, individual states can determine whether or not to offer certain optional aspects of the program. As a result, the Medicaid program may differ significantly from state to state.

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