Health Insurance for Kids w/disabilities

[Hoosier Mama?]

This may not be the most appropriate place to post this, but I'm hoping someone here will have had some experience with this and can give some suggestions.

My son's 7y/o friend has a few medical concerns...I'm not clear on all the details, but apparently he isn't medically insurable. According to his mother, his paternal grandparents are quite wealthy and regularly deposit a large sum into an account to help pay for his medical needs. I'm assuming that this extra income prevents them from qualifying for any gov't aid/ins.

Although it seems that his immediate medical needs are taken care of, the lack of health insurance is preventing him from signing up for sports, as they require proof of insurance. He wants to play sports so badly, and I'd love to be able to find a way that he'd be able to.

Any suggestions greatly appreciated.

[FabTXMomma]

Forgive me for posting here as a newbie, but I thought this information would help. We have a 6 year old son with autism, and we have been advised to set up a special needs trust in order to protect our son's eligibility for Medicaid and other govt benefits. We have contacted an estate planner that specializes in special needs financial and estate planning.

Perhaps a special needs trust or something similar could help here? If that extra income from the grandparents is the only thing preventing them from qualifying for Medicaid, perhaps it could be put into a trust and thus not be counted against them? Here's some basic info on what a special needs trust is:

http://www.nolopress.com/article.cfm/ObjectID/99F4B4FB-8170-4ACB-93B4688F4E0F7247/catID/F251EA55-13A9-4EE0-85D21CEB27636030/309/298/ART/

And some more info on how it works:
http://www.fragilex.org/html/trust.htm

The family may want to contact a local disability advocacy organization, such as the ARC, and ask for information on setting up a special needs trust for their child. They may be able to point her to a lawyer or estate planner who specializes in special needs financial planning.

[CanRelate]

Fab has good suggestions.....

It needs to be an attorney/organization well-versed in how Medicaid and Medical trusts interact. Medicaid can vary some from state to state in the categories of coverage and the application process. Indiana is a particularly funky state in that respect. (I lived there for several years.....I am just saying the rules are funky, not that there is anything wrong with Indiana!!!!)

In the meantime, consider the grandparents pay the bills directly as the bills come in. That way the monies are not resources/assets that could be counted against the family in trying to get Medicaid or other things for the child.

I wonder why the child is uninsurable under what I am guessing is employee family plan under one of the parents.... Sometimes the exclusions of pre-existing conditions are time limited.

Sometimes there are low premium catestrophic only plans --- they don't cover co-pays and general things, but from what you say "proof of insurance" is the most pressing issue. Does the "proof" documentation require more than the name/address/policy number/name of insured information? I would be surprised if a sports program had the ability to require detailed policy rider information.

Or alternately, will they not take an notorized affidavit of self-insured? I *think* the main issue is liability, so if the affidavit gets the school off the hook ---- as far as any other insurance coverage declaration would --- wouldn't that be enough?

Is the coverage state mandated? Get a copy of the mandate. Does the school system or specific school have written policy regarding this? Get a copy. If either of these documents exist, they may mention the various kinds of "proof" which are acceptable to be able to participate.

Since the grandparents have the means, it sounds as if paying an actual attorney would not be a burden whether it is in getting the immediate participation obstacles ironed out in terms of options, AND in getting the medical trust investigated and set up.

Hope he can participate soon!!!!

Regards,
CanRelate