Medicaid and Cerebral Palsy

Children with birth injuries have unique health care needs. Without access to the proper medical services, they are at a higher risk of developing complications and illnesses related to their condition. Medicaid helps many special needs children get the care they require to stay healthy and live productively.

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What is Medicaid?

Medicaid is a federal and state program designed to help fund medical care for people with low income and limited resources. It covers certain disabled children ages 3 to 21, the elderly, pregnant women, blind individuals and disabled adults. Under Medicaid, a qualified child with cerebral palsy is fully covered for all services considered medically necessary by the child’s health care provider. These services may include:

  • Psychological and behavioral services
  • Inpatient/outpatient treatment programs
  • Medications
  • In-home nursing care
  • Transportation
  • Medical supplies

Medicaid coverage also applies to certain communication devices designed for children with cerebral palsy and other impairments. The program does not, however, cover rehabilitation or educational services.

Does My Disabled Child Qualify for Medicaid Benefits?

Your family must earn below a certain income level — which varies from state-to-state to qualify for Medicaid coverage. You must also meet other criteria, such as being a U.S. citizen or lawfully admitted immigrant (this is based on the child’s status, not that of the parents). In some cases, children who are classified as being “severely disabled” under the program can obtain Medicaid coverage regardless of the parent’s income.

Each state has its own specific income requirements for Medicaid eligibility.

Medicaid Rights

You should consider Medicaid if your disabled child needs health care and your family’s income is low. Even if you aren’t sure about whether or not your child qualifies for this type of coverage, your best bet is to complete an application. A caseworker can evaluate your individual circumstances and determine your child’s eligibility. View a questionnaire that can help you determine which federal benefits programs your child may be eligible for.

By law, children with a disability have certain rights under the Medicaid program. You and your child are entitled to:

  • Receive a clear explanation of the benefits process
  • Receive the assistance of a translator if necessary
  • Apply for Medicaid benefits without a home address if you are homeless
  • Be evaluated for possible retroactive benefits extending back three months
  • Receive an Access card (proof of Medicaid coverage) immediately, if necessary
  • Receive written notification and a hearing if benefits are denied or discontinued
  • Appeal a denial or discontinuation of Medicaid coverage
  • Receive benefits until an appeal is decided if filed within 10 days of the notice
  • Be treated with dignity and respect throughout the application process

Apply for Medicaid

Contact your local Medicaid office for information on eligibility criteria and how to apply for coverage for your child. View a state-by-state directory of Medicaid programs.

Learn about disability income through Supplemental Security Income (SSI) for children with cerebral palsy and other birth injuries.

You may also be entitled to money if your child has cerebral palsy that was caused by negligent medical care. Sokolove Law represents families in cerebral palsy cases resulting from substandard care. Our medical team will listen to your concerns and help get your questions answered.

Author:Sokolove Law Team
Sokolove Law Team

Contributing Authors

The Sokolove Law Content Team is made up of writers, editors, and journalists. We work with case managers and attorneys to keep site information up to date and accurate. Our site has a wealth of resources available for victims of wrongdoing and their families.

Last modified: October 13, 2021