Guest guest Posted June 29, 2004 Report Share Posted June 29, 2004 Maybe someone could take a note of this, and remind me, and we can ask Dr. Kirt , who will be providing free dental exams at the convention for all our RSS/SGA families on Friday night. He is the director at Univ of Arkansas Children's, and he may know of stuff. We can also ask Dr. H. Can someone make a note of this -- my head is already filled up with other stuff.... > I read all the posts regularly and it's so helpful having this group. I don't post often at all (sorry) and am just looking for some advice. My daughter (RSS 11 years old, 50lbs, 44 inches) will be getting braces soon. This will be a costly visit.... our dental insurance does cover some orthodontist care but not much. I was wondering if anyone knows of there being some sort of state funding for braces, etc. for children with a medical need ... thought maybe I read about it somewhere?? Or maybe braces/orthodontist care would be covered our health insurance because of RSS? Maybe I'm crazy but thought I would ask. > > Thanks so much for all your support!! > > Revels > Richmond, VA > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 30, 2004 Report Share Posted June 30, 2004 , I live in Northern Virginia (Fairfax County). I just went to a seminar about a month ago regarding Medicaid Waivers in Virginia (there are six in all I believe), which are for people with long-term care needs. They are NOT based on parental income. I'm not sure whether you are familiar with them or not. My son, Jake is 4 1/2, RSS and is currently on the non-urgent wait list for the MR (Mentally Retarded )Waiver. He is not mentally retarded but in Va. that is where they put kids who are under 6 with developmental delays. We are also in the middle of the process of trying to get him approved for the E & D Waiver (Elderly and Disabled). If your child is approved for a waiver in Virginia then the child gets the benefits of that particular waiver (for example: respite care, skilled nursing, or maybe environmental modifications). But they also get full medicaid benefits. They get a medicaid card, which can be used as a seondary insurance to your existing medical insurance. Then you can get HIPP (Health Insurance Prepayment Program) which in essence reimburses you for your portion of out-of-pocket premiums to cover your daughter on you private health insurance plan. Medicaid wants you to have private insurance, because then they bill them first for your daughter's medical bills and they pick up where they left off. Now here is the part that you asked about: if you can get your daughter qualified for a waiver then she is eligible for EPDST (Early and Periodic Screening, Diagnosis and Treatment) which means she gets the following services as well: immunizations, checkups and lab tests, mental health assessment and treatment, health education, eye exams and glasses, hearing exams and hearing aids and implants, DENTAL SERVICES, personal care, nursing services, and other needed services, treatment and measures for physical and mental illnesses and conditions. Sorry to ramble here, it is just such a well kept secret. I hate it!!!! If you are interested in applying, just let me know I can try give you contact numbers, and pass along what I have learned along the way. Each waiver has its own set of criteria you must meet. Alison > I read all the posts regularly and it's so helpful having this group. I don't post often at all (sorry) and am just looking for some advice. My daughter (RSS 11 years old, 50lbs, 44 inches) will be getting braces soon. This will be a costly visit.... our dental insurance does cover some orthodontist care but not much. I was wondering if anyone knows of there being some sort of state funding for braces, etc. for children with a medical need ... thought maybe I read about it somewhere?? Or maybe braces/orthodontist care would be covered our health insurance because of RSS? Maybe I'm crazy but thought I would ask. > > Thanks so much for all your support!! > > Revels > Richmond, VA > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 30, 2004 Report Share Posted June 30, 2004 , I have gone through the same problems you are going through and have gotten nowhere. saw Dr Kirt at the convention last year, who was very helpful. He directed me to some craniofacial clinics in my area for an evaluation. To be honest, not only did I not know about craniofacial clinics, even if I did know about them, I would never have thought would have qualified for this as a RSS kid. Anyhow, at the craniofacial clinic, he was evaluated all day by a team of all different kinds of doctors/specialists, including dental & orthodontics. This visit was free believe it or not, but they did bill a portion of it to my HMO insurance. If you do not have insurance, the craniofacial clinics have to accept you anyway for free, even if you are not on Medicaid. At the end of the visit you get a full report from all the specialists with their recommendations. The orthodontic recommendation for was to be seen at a nearby dental school. I was told that any referrals coming from this visit would either be covered at no cost, because they take research cases or the fees would be considerably lower than going in as a private patient. I forgot to mention that I also have dental insurance & have taken to 2 participating orthodontists on the plan who wouldn't touch him, saying he needs to be seen in a medical clinic setting. The dental insurance won't cover anyone outside the network, despite the fact that their participating doctors won't treat him. We did go to the dental school & the fees were not lowered at all - it is very costly. After paying for an evaluation, x-rays, and impressions, they told me they wanted to wait a little longer for braces, thus this will all need to be repeated again when he is really ready. I also tried to get my medical insurance to cover this since his dental condition is related to his medical issues, but they would not. The dental school wouldn't have accepted insurance anyway. I'd be interested to see if anyone else responds to your e-mail, as I could use some help too! We don't qualify for any type of financial assistance. The only advice I can give you is that if you are attending the convention, make sure you see Dr. (craniofacial orthodontist). Kim C. > > I read all the posts regularly and it's so helpful having this > group. I don't post often at all (sorry) and am just looking for > some advice. My daughter (RSS 11 years old, 50lbs, 44 > inches) will be getting braces soon. This will be a costly > visit.... our dental insurance does cover some orthodontist care but > not much. I was wondering if anyone knows of there being some sort > of state funding for braces, etc. for children with a medical > need ... thought maybe I read about it somewhere?? Or maybe > braces/orthodontist care would be covered our health insurance > because of RSS? Maybe I'm crazy but thought I would ask. > > > > Thanks so much for all your support!! > > > > Revels > > Richmond, VA > > > > > > Quote Link to comment Share on other sites More sharing options...
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