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Medical Assistance in Pennsylvania (Before 18)

Updated: Apr 22, 2022



When Ben was first diagnosed with Autism his actual diagnosis was:



PDD-NOS Pervasive Developmental Disorder - Not Otherwise Specified


we were plunged into a world with acronyms we were not familiar with and terms we didn’t understand. One important avenue of information came from parents that were ahead of us on the journey.




In 2000 the statistics were 1 in 154 for children with autism and currently in 2022 it is 1 in 54.




We loved being a part of Special Olympics Basketball where Ben met and made friends while exercising and we sat and bonded with the parents who shared their accumulated wisdom.



 


Living in Pennsylvania, we were fortunate to have access to Medical Assistance as a secondary insurance for Ben.


It was not dependent on our family’s income but rather his diagnosis.


The major initial benefit for us was speech therapy. My husband paid monthly for insurance through his work but they would only pay for restorative speech and not developmental speech. So if Ben had an accident and forgot how to talk they would pay but since he never developed speech they would not cover the service.


We were so grateful to find out that the Medical Assistance covered every speech session 100% and paid for 3 years of therapy until he started school and then received the therapy through the school district.



Another thing that was covered was pull-ups disposable diapers as it took Ben several years past typical children to be dry through the night. This was a huge financial savings for us as well.


You can check their website linked here or above for the initial application for Medical Assistance.







 

There are step by step instructions on how to apply on the website. You will probably be denied the first time you apply but don't give up - just follow up and reapply. They will ask for information for everyone who lives in your home but the approval is not dependent on income but rather the diagnosis of your child.



Once you are accepted into the ACCESS program you will then choose an insurance provider. If you have other insurance, that will always be primary and the medical assistance secondary. The ACCESS program also allows you discounted admission to many museums and art related activities in the area.

You can find more information about this program on their website linked above as well as on our autism resources page.



Love you more,

Mom





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