Benefits

Having a child with special health care needs can cause financial stress on a family. There are costs for visits to specialists, therapy, medical equipment, assistive technology, medications, and home modifications. Contact your pediatrician, early intervention team or the WVU Center for Excellence in Disabilities to learn more about the programs and benefits for children with disabilities in West Virginia. If you are enrolled in the WV Children with Special Healthcare Needs (CSHCN) program, you can contact your CSHCN Care Coordination social worker to learn about services available.

Health insurance is tricky, but your CSHCN Care Coordination team and/or service coordinators can help.

• Know your family’s benefits and insurance. This is your road map to paying for services.
• Don’t be afraid to appeal a decision if your insurance won’t approve a service your child needs. It is your right, and many denials are overturned when a parent appeals.

Government health
benefits, insurance programs and financial resources

• Medicaid

  Medicaid is a government program that provides medical services for people who meet certain income or disability requirements.

• Children’s Health Insurance Program (CHIP)

  A program that offers coverage to children aged 18 and younger at low cost. The fees depend on family income levels.

• Children with Special Health Care Needs (CSHCN)

  A state program that offers extra health care benefits for children under the age of 21 who have disabilities.

• Health Insurance Premium Payment (HIPP)

  A program that helps families pay for health insurance if someone in their family gets Medicaid and/or if someone in their family can get private health insurance through their job.

• Personal Care Services Program

  An in-home care program for West Virginia Medicaid members who may need help with their Activities of Daily Living (ADL). Trained direct-care workers come to your home, place of employment, or community to assist with ADLs and other areas of personal care to help you live independently. Includes a downloadable application.

• Supplemental Security Income (SSI)

  SSI provides monthly payments to people with disabilities, including children, and older adults who have little or no income or resources. Learn more about how to apply online, or learn how you can help determine a child’s eligibility as a school professional.

• Supplemental Security Insurance (SSDI)

  A government program that is based on financial need and helps pay for living and health care expenses for children with disabilities and special health care needs. If you are approved to get Medicaid, you also can be approved to get SSI.

• Waivers

  Waivers let states use Medicaid funds to offer long-term home and community-based services to people with disabilities and special health care needs – and people who are elderly – to help them live in the community. Waivers are not a kind of insurance. Unlike other programs, many waivers are based on your child’s, not your family’s, income. You might have to wait a very long time to get waivers, so it’s best to sign up as soon as you can.

• WV ABLE

  WV ABLE makes STABLE accounts available to West Virginians with disabilities. STABLE accounts allow you to save and invest money without losing eligibility for certain public benefits programs like Medicaid, SSI or SSDI. Earnings in STABLE accounts are not subject to federal income tax, so long as you spend them on qualified disability expenses.