Medical Assistance
Despite some families having medical insurance, there are many services and items children with special needs may require that fall outside the scope of their primary health benefit coverage and/or the financial means of the family. Additionally, there remain many families without any healthcare insurance coverage that otherwise would be completely unable to provide the support a child with a disability may require to develop and grow to their fullest potential, and to be able to achieve academically.
The Medical Assistance (MA) program may offer these children support, tools, and hope for a bright future.
The Bucks IU helps families understand the eligibility requirements and to navigate the system and paperwork process to become enrolled in Medical Assistance and receive coverage.
This voluntary program is unique, as there is no cost limit or ceiling for eligible participants. It is offered at no cost to the families, and participation is not based on the family income level, but rather on the child’s diagnosis or disability (eligibility exception available within Pennsylvania). With medical expenses covered, families are better able to make important health-related decisions regarding their child’s unique needs and requirements. Eligible children are also provided health care coverage even if their families do not have insurance of their own.
School Based ACCESS Program (SBAP)
In 1992, The PA Department of Education in collaboration with the Department of Human Services initiated the School Based ACCESS Program (SBAP) as an avenue for school entities to receive additional federal funding through Medicaid dollars. This supports medical/mental health-related special education services rendered by qualified staff to students enrolled in the PA Medical Assistance (MA) program. Any participating school district, intermediate unit, or approved private school may seek partial reimbursement from MA for health care related services that they provide to students in the school setting under the terms of the child’s Individual Education Plan (IEP). Eligible services include therapies such as occupational, physical, and speech as well as nursing services (RN and LPN), orientation and mobility services, personal care assistance, social work, psychological, hearing impaired services, and specialized transportation.
The Bucks IU helps families understand the eligibility requirements and to navigate the system and paperwork process to become enrolled in Medical Assistance and receive coverage.
Parents are asked for their permission to bill Medical Assistance and then are notified annually thereafter. Reimbursement funds received for services provided for students must be utilized to meet the increasing needs of all special education students. Federal and state regulations require that funding be invested in special education services, and specific guidelines are provided for spending the money received.