Medical Coverage

Depending on the specific special needs, a child turning 18 could require significant healthcare or require no immediate coverage. Some parents have health insurance that covers their child with special needs if the child is still living at home due to significant disability. However, each health insurance company’s definition of a disability may or may not match the SSA’s, the insurer may not offer coverage for the specific drugs or services the child requires, or it may not offer coverage for adult children with disabilities at all, making it all the more important to review the family insurance policy to determine what further coverage a child’s condition requires.

If a parent’s private insurance is not going to provide the coverage their child needs and the child will not receive coverage through employment, then the individual must seek Medicare or Medicaid coverage. As explained above, access to SSI automatically qualifies a beneficiary for Medicaid, and SSDI recipients begin receiving Medicare two years after beginning to receive SSDI payments.

These are not the only ways to obtain government-funded healthcare. Individual states may offer Medicaid to adults with disabilities who meet different income or asset requirements. Furthermore, some states offer working adults with disabilities discounted health insurance or access to supplemental insurance that may improve upon the benefits provided by an employer.

Harry S. Margolis practices elder law and special needs planning in Massachusetts and is a co-founder of the Academy of Special Needs Planners.

Eric Prichard is a freelance writer who focuses on special needs and elder law. He is also a licensed Massachusetts attorney.


EP_Logo_partners_page.jpg Reprinted with permission from Exceptional Parent, the family and professional journal for the special needs community. Exceptional Parent is the media Partner of My Child Without Limits.

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