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Transition to Adult Life
If your child is covered by Wisconsin Medicaid, do you really know all the important benefits that are available? You probably know that your child’s ForwardHealth card (a.k.a. Medicaid insurance card) covers the cost of seeing the doctor, but you may not realize it also covers so many other important services, supports and products you need to keep your child safe and healthy at home!
What Can Your Medicaid Card do for You?
Here’s a description of some of the Medicaid covered items and services that are most helpful for families who have children and teens with disabilities.
Personal Care Services: Medicaid can pay for someone to help your child with daily living activities in your home. This can include help with feeding, bathing, toileting, dressing, meal preparation and laundry. Your family will work with a Home Health or Personal Care Agency in your area to find and hire the workers who will come into your home. Our Fact Sheet on Personal Care Services has more detail on this benefit.
Tip for Families:
For Medicaid to cover these items, you likely will need a prescription from your child’s doctor to document that the service is medically necessary (Definition: HFS 101.03(96m), Wisconsin Administrative Code). The provider may also need to submit a prior authorization request to Medicaid. See our Family Voices Fact Sheet on Insurance Prior Authorization for a complete explanation.
Non-Emergency Medical Transport: Medicaid can pay for, and make arrangements for, transportation to medical and therapy appointments. You can also ask for reimbursement if you drive your own car to appointments. You’ll need to contact Medical Transportation Management (MTM) mtm-inc.net/Wisconsin, to schedule rides or request mileage reimbursement. Schedule rides at least two days in advance and, if it’s your first time using this service, or you’re in a rural area, allow as much as two weeks for scheduling. For more details see our Medicaid and Transportation Fact Sheet.
Diapers and other Incontinence Supplies: Starting when your child turns age 4, Medicaid will cover the cost of diapers and other related supplies like disposable pads, liners and gloves. (Wipes are not included as a Medicaid benefit.) You will need to work with J & B Medical Supply to have these items shipped directly to your home. Our Fact Sheet on Diapers and Incontinence Supplies has more detail about this.
Over-the-Counter Medications: Medicaid can be used to cover the cost of products that you typically buy at a pharmacy. Things like vitamins, laxatives, ointments, iron supplements and melatonin can be covered if your child’s doctor has prescribed them. These supplies will most likely be covered under the HealthCheck “Other Services” (HCOS) Medicaid benefit. See our HCOS Fact Sheet to learn more.
Tip for Families:
Bring your ForwardHealth with you to every appointment and trip to the pharmacy. And, make sure your child’s providers have both private insurance and Medicaid card numbers!
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