Children with Special Health Care Needs, as defined by the Social Security Act, are eligible to receive a number of government benefits to pay for their care, services, and medical aid. There are many ways a child can qualify as a Child with Special Health Care Needs (CSHCN), though it usually comes down to suffering from certain conditions, such as Down’s Syndrome, ADHD, cerebral palsy, and autism. The following is a list of the benefits that are available to children with special needs in California.
Medi-Cal is a needs-based program, so eligibility is reliant on income and asset limitations. Many children with special health care needs from lower-income families may automatically qualify for Medi-Cal benefits. However, other children with special needs are eligible for Medi-Cal benefits if a certain level of institutional care is required, regardless of their income level.
In addition, the families of children that spend a large amount of money on health care, as well as children placed in foster homes, may also qualify for Medi-Cal automatically, although each individual situation is different. You should speak with an experienced special needs attorney to determine if your child can qualify for Medi-Cal under CSHCN rules.
State Children’s Health Insurance Program (SCHIP)
SCHIP is a federal program that is available to children with special needs who do not qualify for Medi-Cal. While SCHIP is similar to Medi-Cal, there are some important differences. First, SCHIP typically does not cover as many services as Medi-Cal, and the state of California has more control over SCHIP than it does over Medi-Cal. Additionally, SCHIP is available to children with special needs whose family income level is around 200% – 300% above the poverty level. A special needs lawyer can tell you if SCHIP is an option available for your child.
Maternal Child Health Bureau Agencies
The Maternal and Child Health Bureau is tasked with caring for the well-being of new mothers and their infants as well as children with special needs. The Maternal Child Health Bureau Agencies have developed many programs to serve children with special health care needs and their families. Most of the time, the federal grants given to these agencies are used to pay for aid and services that are not typically covered by Medicaid or SCHIP.
If you would like to get more information about the benefits available to your child with special needs, or if you’d like to start special needs planning to ensure your child is taken care of in the event of your death or incapacitation, please set up an appointment at our Encino special needs planning office by calling (818) 905-6088.