- Health Insurance Marketplace HealthCare.gov
- State Children's Health Insurance Program (S-CHIP)
- Social Security Benefits
- State Title V CSHCN Programs
Early Periodic Screening, Diagnosis and Treatment (EPSDT) (named CHEC in Utah) is a federal provision that requires Medicaid to provide medically necessary health care services for children under 21, even if the service is not available under the Medicaid State Plan. Other services include immunizations, hearing, vision, and dental screenings, and any medically necessary treatments for physical or mental illnesses if they are discovered in the screening process.
Medicaid Home and Community-Based (HCBS) Waivers provide a variety of services to consumers under an approved waiver program. The number of services that can be provided is not limited. Programs may provide a combination of both traditional medical services (i.e., dental services, skilled nursing services) as well as non-medical services (i.e. respite, case management, and environmental modifications). States have the discretion to determine the number of consumers to serve in a waiver program. Eligibility is based on the income of the individual with the special need, not the family's income, therefore allowing more children with disabilities who meet the state’s criteria to be eligible for Medicaid and Waiver services.
Medicaid applicants whose income exceeds the monthly income standard may be considered for the Medically Needy or Spend-Down program, sometimes referred to as the Excess Income program. This program allows a person who is otherwise eligible either to pay "excess" monthly income to the state, or to accept responsibility for a portion of his or her monthly medical bills. For detailed guidelines, see Medicaid Excess Income Program.
For state specific information: State Medicaid Programs
- Has a chronic renal disease and needs a kidney transplant or maintenance dialysis
- Has Lou Gehrig’s disease (ALS - amyotrophic lateral sclerosis).
- If you don’t have insurance and don’t have access to affordable, quality employer-based insurance, you can use the marketplace.
- If you make less than 400% of the Federal Poverty Level and don’t have access to employer-based insurance, you may get cost assistance through the marketplace.
- If you make less than 133% of the Federal Poverty Level, you will qualify for Medicaid if your state expanded Medicaid.
- You may apply on the Health Insurance Marketplace during yearly open enrollments to access cost assistance. If you qualify for a special enrollment period or are looking to see if you qualify for Medicaid or CHIP services, you may apply any time.
- The child must not be working and earning more than the specified amount that Social Security set for the year. The amount usually changes each year due to the cost-of-living increase.
- The child must have a physical or mental condition, or a combination of conditions, that result in “marked and severe functional limitations.” This means that the condition(s) must very seriously limit your child’s activities.
- The child’s condition(s) must have lasted, or be expected to last, at least 12 months; or must be expected to result in death.
- must be receiving Social Security retirement or disability benefits; or
- must have died and have worked long enough under Social Security.
- Health Coverage Tax Credit
- Earned Income Tax Credit
- Child Tax Credit
- Dependent Care Tax Credit
- Tax Credit for the Disabled and Elderly
National Center for Family - Professional Partnerships (F2F HICs)
Family-to-Family Health Information Centers (F2F HICs) are nonprofit, family-staffed organizations that assist families of children and youth with special health care needs. State-based F2Fs provide support, information, resources, and training around health care funding. Staff is uniquely able to help with firsthand experience navigating the maze of health care services and programs.
Take Care Utah
Health insurance outreach and enrollment assistance to Utah residents. Also provides training and resources to community-based organizations that assist Utah's diverse populations and needs. All services are provided free of charge; a partnership between the Association for Utah Community Health (AUCH), the Utah Health Policy Project (UHPP), and the United Way 2-1-1.
Utah Medical Programs Summary ( 189 KB)
A broad view of the medical programs in Utah, Utah Department of Health, including Medicaid Disability Program, also referred to as ABD Medicaid, and the Medically Needy Spend Down Program. 2014
DSPD Intake Form Utah ( 1.8 MB)
Division of Services for People with Disabilities Intake checklist and forms, including the Medicaid DSPD Community Supports waiver. Once on waiting list there is funding for critical needs when available. Care Coordinator call DSPD case worker with parent's consent.
Family Voices is a national, nonprofit, family-led organization promoting quality health care for all children and youth, particularly those with special health care needs. Locate centers by state, F2F HICs (Family-to-Family Health Information Centers).
Catalyst Center: Financing Care for CSHCN
The Catalyst Center is dedicated to improving healthcare coverage and financing for children and youth with special health care needs (CYSHCN). It is funded by the federal Maternal and Child Health Bureau, Health Resources and Services Administration, and US Department of Health and Human Services.
Social Security Benefits for Children with Disabilities
An electronic booklet outlining the kinds of Social Security and Supplemental Security Income (SSI) benefits a child with a disability might be eligible for; call toll-free 1-800-772-1213.
Managing Your Finances
An online tutorial from the PACER Center, "Managing Your Finances" includes these modules: Make a Spending Plan, Track Your Spending Leaks, Set S.M.A.R.T. Financial Goals, Manage Your Debt, and Protect Your Identity.
Need Help Paying Bills?
Information on assistance programs, charity organizations, and other resources listed by state for help paying bills, mortgage and debt, how to save money, and tips to pay bills when money is tight.
UnitedHealthcare Children's Foundation
The UnitedHealthcare Children's Foundation is a nonprofit charity. Apply for grants for medical needs not covered or not fully covered by a commercial health insurance plan.
US Department of the Treasury Health Savings Accounts
Taxpayers can find out more about Health Savings Accounts here.
A free information and referral line for health, human and community services. 2-1-1 provides information and referral on topics such as emergency food pantries, rental assistance, public health clinics, child care resources, support groups, legal aid, and a variety of nonprofit and governmental agencies. Call for quick answers. The online directory provides anytime access to the same information. Confidential and free.
Health Insurance Marketplace HealthCare.gov
Also known as the health insurance exchange, the Health Insurance Marketplace helps uninsured people find health coverage that meets their needs and budget. Part of the Affordable Care Act.
Healthcare Financing Factsheet ( 263 KB)
A series of one page healthcare financing fact sheets from focus groups of physicians, nurse practitioners, and other healthcare providers assembled by Family Voices New Jersey, 2011.
Healthcare Financing Factsheet, Spanish ( 319 KB)
In Spanish, a series of one page healthcare financing fact sheets from focus groups of physicians, nurse practitioners, and other healthcare providers, assembled by Family Voices New Jersey, 2011.
National Disability Navigator
This fact sheet is intended to help Navigators answer specific questions that people with disabilities might ask about benefits and coverage available through the Health Insurance Marketplace, supported by the American Association on Health and Disability (AAHD).
Children's Health Insurance Program (CHIP)
This is the official U.S. government site for CHIP services; information includes eligibility, enrollment and general information about health insurance for kids.
Tutorial on Medicaid and CHIP Health Insurance
A tutorial on the basics of Medicaid and CHIP, the many different populations these programs serve, the changes they are undergoing as a result of health care reform and some options to help readers think about opportunities to improve services for CSHCN through communication and collaboration with Medicaid and CHIP staff. A collaboration of NASHP and the Catalyst Center.
EPSDT Fact Sheet (Early Periodic Screening, Diagnosis and Treatment) ( 48 KB)
Medicaid’s child health component, known as the Early Periodic Screening, Diagnosis and Treatment (EPSDT) program, has been shaped to fit the standards of pediatric care and meet the special physical, emotional, and developmental needs of low-income children. Prepared by Utah Family Voices.
EPSDT Medicaid Benefits for Children
Medicaid's EPSDT benefit provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid. EPSDT is key to ensuring that children and adolescents receive appropriate preventive, dental, mental health, and developmental, and specialty services. Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)
Prepaid Mental Health Plans Coverage by County
Mental health services for Medicaid listed by county, with contact information. July 2015, Division of Medicaid and Health Financing, Utah.
Disability Medicaid Fact Sheet, Utah ( 48 KB)
Information, tips, and resources about Disability Medicaid in Utah. Prepared by Utah Family Voices.
State Title V Snapshots
Title V programs for children with special health care needs (CSHCN) with measures and goals. Maternal and Child Health Bureau, Federal-State Partnerships
Supplemental Security Income (SSI)
The Supplemental Security Income (SSI) program pays benefits to disabled adults and children who have limited income and resources.
Social Security Administration
Official site for the U.S. Social Security Administration; offers programs including disability benefits (SSDI) and Supplemental Security Income (SSI).
State Title V Profiles and Contacts
Title V programs by state with contact information. Association of Maternal and Child Health Programs
State-sponsored tax-favorable ABLE accounts for people with disabilities who became disabled before age 26, becoming available in 2016.
Internal Revenue Service
Income tax information.
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