Informational

Does Medicaid Pay for Special Needs Car Seats? 

Many parents asked us whether Medicaid Pay for Special Needs Car Seats or not. The good news is, in some cases, Medicaid may help to cover the cost of your special needs car seat. Of course, there are rules, exceptions, and an application process. 

But don’t fret! This post aims to help you better understand the policies concerning Medicaid and special needs car seats. If you need a special needs car seat check out the special needs car seats post.

Will Medicaid Cover Special Needs Car Seats? 

Adaptive car seats can often be costlier than conventional seats. The amount varies with the type of seat, and how specialized it is. Regardless of the price tag, you are probably wondering if there are any options available to you to help cover the cost. 

In some cases, Medicaid will help cover the expense of a special needs car seat. Medicaid provides health coverage, either in part or in full, to low-income children in the US. To enlist Medicaid’s help, you need to first be a Medicaid enrollee. There are various rules and guidelines concerning who can enroll in Medicaid. 

How To Apply For Medicaid Assistance For a Car Seat

  1. Know the guidelines. Certain things may preclude you from applying to Medicaid, and in turn, receiving assistance. Nationality is one such guideline. To apply you must be a US citizen. 
  2. Gather Your Documents. To apply you will need various documents showing your earnings, income, and dependents. 
  3. Note Your Disability. Even if your earnings are above the minimum, those with specified disabilities may still be able to receive assistance. 
  4. Apply. Fill out the online application specific to your state. Further information can be found here, https://www.usa.gov/medicaid.  
  5. Take the Course. In most cases, Medicaid will ask that you enroll in and take a short car seat safety course. 

Am I Guaranteed Coverage? 

Navigating the complex world of Medicaid can be difficult. And sadly you are not guaranteed assistance. Many times you can contact your State or even the hospital where your child’s medical team resides for application assistance and further help. 

Even though some may be denied, Medicaid is often more likely to cover adaptive car seats than traditional insurance. This is thanks to a regulation known as EPSDT. This regulation requires all medically necessary items for children eligible for Medicaid to be covered. 

Early and Periodic Screening, Diagnostic and Treatment (EPSDT) “benefit provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid”.

Additionally, unlike traditional insurance companies, under Medicaid car seats are seen as medically necessary. Most other insurance companies will, unfortunately, view car seats as “conveniences” and therefore will not cover them. 

But, if you have Medicaid and a doctor deems an item, such as a special needs car seat, to be medically necessary, EPSDT demands that the state must pay for it. 

What If Medicaid Will Not Cover It 

If Medicaid will not cover it or if you don’t qualify for Medicaid, below are few alternatives.

Medicaid Waivers

If Medicaid will not cover the cost of a special needs car seat, you do have other options. The first being a Medicaid Waiver. These waivers are supplied to states so that they can extend Medicaid to children with disabilities. This usually happens via federal and state programs. 

A Medicaid waiver can help cover the cost of a special needs car seat even if you exceed the income level required to receive Medicaid. However, some programs impose limits on their waivers and the benefits they provide. A list of waivers broken down by state can be found at http://www.kidswaivers.org/

The world of assistance programs is undoubtedly complex, and understanding the types of waivers can be difficult. In general, 1915(c) and TEFRA/Katie Beckett Waivers are required to provide full EPSDT benefits to children, meaning that in most cases limits on benefits are not imposed. 

1115 Waivers and those offered by individual states may have limitations on benefits packages. In addition, States may restrict how much money can be spent. Typically it is limited either per person or per year. When in doubt, check out each individual waiver to see if your child and their car seat are eligible. 

Local Programs

Again, asking for guidance from your child’s hospital can be a beneficial first step. It is likely that they have experience in this area and have worked with many families in your situation. 

They may even have a list of programs that can help. Some programs include Easter Seals or Safe Kids. Easter Seals is an American non-profit group that supports those with disabilities. Safe Kids is an organization who specializes in protecting kids from unintentional injuries with a primary area of focus being automobile accidents and car seats. 

Also, your local health department may have access to other programs, including loaner programs. Because these car seats cannot be purchased at general retailers and are quite expensive, loaner programs are a popular option. This can be more budget-friendly than purchasing a seat outright. 

Will a Conventional Seat Work? 

If you have exhausted your options for coverage of a special needs car seat, and your child’s medical team approves, you may be able to use a traditional car seat. This is especially true if you plan to use aftermarket accessories. 

Aftermarket accessories can make a conventional car seat more comfortable and safer for your special needs child. These can include things like buckle guard or a chest clip guard that can make getting out of their seat more difficult for your child. 

However, most manufacturers will not approve any aftermarket accessories. Therefore, it is important to weigh the advantages and disadvantages while also working with your child’s medical team. If you do decide to opt for a traditional seat, there are a few features that can be helpful. 

  1. Extended rear-facing weight limits. 
  2. Harnesses that accommodate higher weight limits. 
  3. Multiple recline options. 
  4. High backs and included head and neck support. 
  5. Extra deep sides and armrests or shallow sides and no armrests (depending on your child’s condition). 

Selecting a car seat that has a lot of adjustable features makes the seat versatile and gives it the ability to be tailored to suit your child’s needs. 

Safety For Everyone

Regardless of the seat you choose, having a team of trained professionals on your side will make the experience easier and safer for you and your family. Consult your child’s medical team as well as local car seat technicians and even the NHTSA. This way you can ensure you have the correct seat and that it is properly installed. 

Welcome to my car seat blog! As a mom of 3, I put together with other hard-working moms a highly informative one-stop car seat resource, full with many reviews and buyer guides. I hope you find it invaluable. Thank you for trusting me & my team! - Keren

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