Medical
Assistance for Children
by
Herbert D. Hinkle, Esq. and Ira Fingles, Esq.
Herbert D. Hinkle
Law Office
2651 Main Street
Lawrenceville, New Jersey 08648
(609) 896-4200 or (215) 860-2100
Medicaid (or “Medical
Assistance” in Pennsylvania) is a federal health care program that
can be critical for children with disabilities. Medicaid pays for
all medically necessary care and treatment for an eligible recipient.
Even if a child has private health insurance, Medicaid may pay for
services that most private insurance plans do not cover such as private
duty nursing, medical supplies, or even residential placement.
Medicaid
eligibility generally depends upon a person’s satisfying the requirements
for the federal Supplemental Security Income (“SSI”) program. SSI
is available to disabled people who have limited income (generally,
no more than around $600 per month) and no more than $2,000 of property
(or “resources”). Under the SSI rules, the income
and resources of a parent are “deemed” to be those of the children
living in the home, as well. Thus, many children are ineligible for
SSI even though they are severely disabled.
In
both Pennsylvania and New Jersey, however, Medicaid can be available
to certain disabled children even if their parents’ income and resources
are too great for the SSI program. Pennsylvania’s program is more
generous than New Jersey’s: any child who meets the SSI standards
for being disabled will be eligible for Medical Assistance regardless
of the
parents’ income and resources. (A child whose own income and
resources are too high will still be ineligible, but this can usually
be fixed.)
Unlike
Pennsylvania, New Jersey counts the parents’ income and resources
until the child turns eighteen. to a disabled
child. However, there are a few “waiver” programs that have this effect
for children with certain
types of disabilities. Most of New Jersey’s Medicaid “waiver” programs
have caps on the numbers of people that can be served, but it still
may be worth applying.
Copyright 2002
H.D. Hinkle. All rights reserved.
Mr. Hinkle maintains
a multi-state law practice with offices in Lawrenceville, Florham
Park, and Marlton, NJ, and Yardley, Pa. Mr. Hinkle and his colleagues
Ira Fingles, and Paul Prior lecture and write frequently on topics
of law, aging, and disability, and are available
to speak to groups in New Jersey and Pennsylvania
at no charge. Call (609) 896-4200.
