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Health and Care: Financial Assistance
Government Assistance Programs
National
Centers for Medicare and Medicaid Services, previously the Health Care Financing Administration (HCFA), is a federal agency within the U.S. Department of Health and Human Services. CMS runs the Medicare program, Medicaid program, and State Children's Health Insurance Program (SCHIP). This website offers the latest information on each of these programs.
Medicaid Buy-in is designed to provide access to comprehensive health care for working people with disabilities. It allows working people with disabilities to pay a monthly premium to continue coverage in their state's Medicaid program, an affordable alternative to private health care coverage. Several states have already enacted this program, with many more planning to do so. Eligibility is determined by each individual state. The monthly premium is a sliding scale based on income. For more information call the Centers for Medicare and Medicaid Services at 800-MEDICARE (800-633-4227).
Medicaid Home and Community Based Waiver Program provides states with the option to develop and implement creative alternatives to institutionalizing Medicaid-eligible individuals. This offers individuals the option to be cared for in their homes and communities, rather than nursing homes. Some of the services that may be provided without prior approval of the Federal government through this program include: Case Management Services, Homemaker Services, Home Health Aide Services, Personal Care Services, Adult Day Health Habilitation and Respite Care Services. Other services which may be provided with prior approval include: Transportation, In-Home Support, Meal Services, Special Communication, Minor Home Modifications, and Adult Day Care. Before applying for this program you may want to contact a case worker from a non-profit disability organization. A good place to start is your local Center for Independent Living.
U.S. Department of Health and Human Services via their Health Resources and Services Administration offers the Hill-Burton Program designed to assist low-income individuals in receiving the health care services they need. This is not an all-inclusive insurance program; rather it is designed to cover costs associated with services other than routine doctor visits. Each Hill-Burton facility chooses which services to offer for no or reduced charge. You can apply for this assistance before or after service charges are incurred. Eligibility is based upon family size and income. For more information call the hotline at (800) 638-0742.
State Listings
Connecticut
Connecticut Department of Social Services administers the SAGA and General Assistance Medical program, which provides medical assistance to low-income persons who do not qualify for, or who are awaiting an eligibility determination, for other state or federal medical assistance programs. Eligibility is based on income and assets only. For more information, call (800) 842-2159.
Illinois
Illinois Department of Human Services offers the Home-Based Support Services Program, which tailors services to help adults with eligible disabilities live at home. The program pays for services to help enrolled adults (age 18 or older) become more independent living on their own or with their families. Participating adults are entitled to services worth approximately $17,000 to $19,000 per year. They also offer the Family Assistance Program, which pays a monthly cash stipend to help with the costs of caring for an eligible child (age 17 or younger) with a severe mental disability. Participating families receive approximately $5,000 to $7,000 yearly.
Funds are typically appropriated for the program during the spring session of the General Assembly. If funding is sufficient to allow enrollment of additional persons, new persons are selected by a random drawing during the summer. If such a drawing is held in a given year, families and individuals whose applications are received by May 31 of that year are eligible for the random drawing. To learn more, call (800) 843-6154, ext. 3.
Massachusetts
Massachusetts Division of Medical Assistance manages MassHealth, a program that pays for health care coverage for eligible low to moderate income Massachusetts residents who are under the age of 65. MassHealth covers an extensive list of services including outpatient hospital visits, pharmacy services, physician services, personal care services, dental services and much more. For more information, call (800) 841-2900 or (800) 497-4648 (TTY).
New Hampshire
Medicaid for Employed Adults with Disabilities (MEAD) is a new Medicaid coverage group that allows adults with disabilities to work and earn wages without losing their Medicaid coverage. In general the program makes a person with a significant disability who is employed eligible for Medicaid by removing the poverty requirements of the regular Medicaid rules. Net income must not exceed 450% of the federal poverty level and resources may not exceed $20,000 for a single person or $30,000 for household of two. For more information, contact the New Hampshire Department of Health and Human Services by phone at (800) 852-3345 ext. 4796 or (800) 735-2964 (TDD) 8:00 - 4:30 M-F.
New York
Family Health Plus (FHP), administered by the New York State Department of Health, is a program that makes comprehensive health insurance available at no cost to lower-income, uninsured adults who do not have employer-sponsored coverage and are not eligible for Medicaid or Medicare. Low-income New York State residents between the ages of 19-64 are eligible to apply. Some of the services covered under FHP include, physician services, inpatient and outpatient health care, prescription drugs, lab tests and x-rays, vision, speech and hearing services, durable medical equipment, emergency room and emergency ambulance services, drug, alcohol and mental health treatment, diabetic supplies and equipment, radiation therapy, chemotherapy and hemodialysis as well as dental services. For more information or to apply for this program, call (888) 692-6116.
North Carolina
North Carolina Division of Medical Assistance manages Medicaid and NC Health Choice for Children for the state of North Carolina. Medicaid is a health insurance program for certain low-income and needy people paid with federal, state, and county dollars. Medicaid covers children, the aged, blind, and/or disabled, and people who are eligible to receive federally assisted income maintenance payments. Under the Medicaid Program is the Community Alternatives Program for Disabled Adults which provides home care services as an alternative to institutionalization. For more information, call (919) 857-4011.
Texas
Your Texas Benefits allows individuals to self-screen for potential eligibility for assistance programs provided by the Texas Department of Human Services. STARS screens for medical assistance programs for children and families, the Children with Special Health Care Needs (CSHCN) program, the Community Care for Aged and Disabled (CCAD) program, the Nursing Facility Community Based Alternatives (CBA) program, Medicare and Medicaid, and many others. Visit this website to learn of your eligibility.
Texas Department of Human Services provides direct grant benefits to individuals with physical disabilities to purchase services that enable them to live in the community via their In-home and Family Support Services Program. The program offers assistance for the purchase or lease of special equipment or architectural home modifications to facilitate care, treatment therapy, or general living conditions of a person with a disability. The program also offers assistance for expenses related to medical, surgical, therapeutic, diagnostic, and other health services related to a person's disability, counseling and training programs that help provide proper care of an individual with a disability, respite care, attendant care, home health services, home health aide services, homemaker services and chore services that provide assistance with training, routine body functions, dressing, preparing and consuming food, and ambulating. For more information, call (888) 834-7406(Voice) (888) 425-6889 (TDD).
Virginia
Virginia Department of Medical Assistance Services offers a variety of comprehensive health services to Virginians. Services include an Uninsured Medical Catastrophe program for those under 300% of the poverty level, prescription assistance programs, as well as the State/Local Hospitalization Program (SLH), which is a cooperative effort between the state and local governments that is designed to provide coverage for inpatient and outpatient hospital care, care in approved ambulatory surgical centers and care provided in local health departments. For more information on these and other programs, visit their website or call (804) 786-4231 (Voice), (800) 343-0634 (TDD).
Washington
Washington Health Care
Authority administers Basic Health, a state-sponsored program that provides health care coverage to low-income Washington residents who do not qualify for Medicare. Monthly premiums, as low as $10, are based upon family size, income, age and the selected health plan. Basic Health covers hospitalization, provider visits, emergency services, prescriptions, and many other benefits. Co-payments may apply. For more information, call (800) 826-2444.
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[Updated April 30, 2004]
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