Washington STATE Medicaid
If your child currently has an autism spectrum disorder diagnosis, he or she may qualify for state Medicaid. Enrolling in state Medicaid may help cover the cost of your child’s medical/behavioral services. However, SOAR Behavior Services cannot guarantee payment or coverage regarding your insurance.
Under Social Security law (SSI), a child is considered to have a disability if:
Under title XVI, a child under age 18 will be considered disabled if he or she has a medically determinable physical or mental impairment or combination of impairments that causes marked and severe functional limitations, and that can be expected to cause death or that has lasted or can be expected to last for a continuous period of not less than 12 months.
Steps to Enroll in Medicaid
- Click “See If I Qualify.” This is necessary as it will not allow you to apply for programs you are not deemed eligible for.
- Complete the entire process. Make sure to select that a member of the household has a disability. Autism spectrum disorder (F84.0) qualifies as a disability and will qualify them for Medicaid.
**Please note – The application is for the individual with a qualifying diagnosis ONLY unless otherwise specified by other eligibility criteria (family household income, etc.). Please do not complete the application for FAMILY or for YOURSELF (if you are the parent or guardian). The application must be completed on behalf of the person with the qualifying diagnosis. If filled out incorrectly, the application may be deemed ineligible.
- Upon qualifying for Medicaid, you can begin the process of enrolling.
SOAR Behavior Services accept ALL Medicaid health plans. However, your other healthcare providers may not get all Medicaid healthcare plans. It is highly recommended that you check what insurances are accepted by all current health care providers before selecting a WA Medicaid health plan.
**Please note – Medicaid health plans start on the 1st of every month. As a result of the pandemic, the process is taking significantly longer than usual. Please plan accordingly.
What if my child already receives private health insurance?
Enrolling in state Medicaid may help to cover the co-pays from services and doctor appointments. Your current private insurance will still be your primary, and state Medicaid will then become your secondary if deemed eligible. As stated above, though, SOAR Behavior Services cannot guarantee payment or coverage regarding your insurance.
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For more blog posts by SOAR Behavior Services, visit soarbehaviorwa.com/family-resources.