TJC Lists Funding Options for Medical Care for Children with Medical Needs
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The Tennessee Justice Center (TJC) lists funding options for medical care for children in Tennessee with medical needs.
Some TN families cannot afford to pay out-of-pocket for all the necessary medical services for their children. Tennessee has a few programs to provide children with the medical care and support they require to live healthy fulfilling lives.
Children in low-income families with and without disabilities may qualify for TennCare depending on household income. The services provided to children on TennCare is governed by TennCare Kids. TennCare Kids is Tennessee’s Early Periodic Screening, Diagnosis and Treatment (EPSDT) program. All EPSDT screenings, check-ups, and treatments are free from birth to age 21 for those on TennCare. TennCare Kids makes sure children receive all medically necessary services at no cost to their families.
Families with incomes higher than the limits outlined have some other options to get their children with disabilities enrolled onto TennCare.
Supplemental Security Income (SSI) - SSI provides a monthly check to those with disabilities to assist them. Children and adults on SSI are guaranteed TennCare coverage. There are income limits based on a variety of factors. You can check your child’s eligibility using the Social Security’s Benefit Finder. Learn more about the application process through your local Social Security office.
Employment and Community First CHOICES (ECF CHOICES) - This is a program for individuals of all ages including young children. ECF CHOICES provides a variety of benefits and home and community-based services including employment exploration, personal assistance, and home modifications. These services are in addition to TennCare coverage. ECF CHOICES does have income limits. However, parental income does not count if the child qualifies for nursing home care. It is a good option for children who lose SSI. Find out about all the other services available and how to apply on TennCare’s ECF CHOICES page.
Katie Beckett - The Katie Beckett program is designed to provide supplemental medical coverage for children with severe disabilities in higher income families. There is no set income limit. The program will provide some children with TennCare and other children with monetary support to help pay for some of the medical services they need. This is an exciting new program with lots of potential.
Other notable programs in Tennessee which provide medical services and assistance to children with disabilities:
Tennessee Early Intervention System (TEIS) -This program is specifically for children under age 3 with developmental delays and disabilities. Older children can receive TEIS-type services through their school system. It helps families find and access resources to support children in their development. There are no income limits or citizenship requirements. The evaluation and service coordination are free of cost and the services are usually covered by insurance policies. For uninsured individuals, the services are provided at a low-cost. Check out TEIS page to learn more about what it offers and how to start the process.
Children’s Special Services (CSS) - The program provides reimbursement for medical services and care coordination for those children who have qualifying diagnoses and met the financial requirements. Children up to age 21 with physical disabilities and special health care needs may qualify for CSS assistance. CSS has income limits, but there are no citizenship requirements. It is available to children regardless of their health insurance (uninsured, private, TennCare). To see if your child is eligible and begin the application process, contact Tennessee’s Department of Health, Family Health and Wellness Division.