Medical Assistance and pump coverage

Hey guys I am in the process of putting together a special needs trust for my son, at the time he would need this he would likely be receiving health benefits through medical assistance my question is…what’s paid for , what’s not…co-pays etc. Any info would be helpful…thanks!

It depends on what state you are in as to what is paid by MA. Here in Pennsylvania, all medical appointments and medications are paid for as well as test strips, but no syringes. Medical Assistance in Pennsylvania will also not pay for insulin pumps until years of hospitalizations due to lows, highs, infections, etc. I’m not sure about your state though because they all do not have the same coverages. Co-pays for physician visits were $2-10 and insulin was free as were test strips. Other meds were nominal charges of $2-5. That was many years ago and I do not know what co-pays are now.

Make sure he is covered under the heading of “life sustaining medication” when you fill out the form. That will guarantee all his diabetic stuff except syringes are covered. Also, check with your local Lions Clubs, Kiwanis Clubs, and service organizations to see what kind of financial assistance they may be able to offer. If they can’t offer financial assistance, maybe they would assist you in fundraising events. Make sure you go to churches, Moose Clubs, and any organization that you have ANY contact with. Even grandparents and aunts and uncles have contacts! Also, make sure you declare this Special Needs Trust for your son or they can make you pay back everything and ruin your credit.