BPDFamily.com

Good Morning-

My daughter recently went on SSI and was told she also qualifies for Medicaid, but she has to go sign up for it.  We have not done this yet.  She is on my insurance at the moment.  We are in Ohio.  Does anyone know if Medicaid covers residential treatment?  If so, I would definately do that.  This is really what she needs.  Do most RTC's take medicaid?

THANKS~

Hi kellygirl,

Here is a site that explains medicaid coverage by state:

www.medicaidbenefits.kff.org/state_main.js (http://www.medicaidbenefits.kff.org/state_main.js)

There is inpatient psychiatric care for under 21: Medicaid refers to RTC's as PRTF's.

Inpatient Psychiatric Services, under age 21

Inpatient Psychiatric Services for individuals under age 21 must be provided under a physician's direction. They may be provided in a freestanding psychiatric hospital or distinct part psychiatric unit of a general hospital or in an appropriately accredited private residential treatment facility (PRTF). If services commence before the individual reaches age 21, they may continue until the earliest of his or her 22nd birthday or the services are no longer required. Admissions often require prior approval, and periodic recertification of a resident's continued need for care may be required as well.

Some states allow payment to these psychiatric facilities to hold or save a bed during a resident's brief acute hospitalization and/or for therapeutic leaves of absence to visit family and friends if medically appropriate. Some states also allow leave days for residents to transition to a community setting. The number of days allowed is identified where applicable. Additional days of leave would require prior approval. Payment for leave days is often at a reduced rate.

States typically reimburse these psychiatric facilities on a "per diem" basis. The per diem may be a standard rate applicable to all facilities, may be facility-specific, or may vary by facility size or location. Generally, a reference in the table to "cost based payment" means there is a year-end facility-specific settlement process, while "prospective payment" means there is not such a process although the payment rates are based on historical cost.

 link above doesn't work - here is the correct one:

www.medicaidbenefits.kff.org (http://www.medicaidbenefits.kff.org)

My daughter is in a RTC with medicaid paying the full cost.  Here in NC they will pay for only certain treatment facilities however, you have to go down every other avenue prior to medicaid approving a residential facility.  It took us almost one full year to jump through the hoops and get her the help she should have been able to get in the first place.  I hope you have an easier time getting her into a RTC.

Gaelen

Check this site as well:

www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Benefits/Early-Periodic-Screening-Diagnosis-and-Treatment.html

Hope that helps.

lbjnltx

Thanks everyone for the info and medicade I am going to need it

We put our daughter in a PRTF in October and immediately applied for Medicaid for her to cover once our insurance stopped paying.  Here in NC, our county office hasn't even looked at her application yet, 3 months later.   I hope your state/county is more on the ball than ours!