Medical Assistance (MA), or Medicaid, is a federal/state insurance program that pays for health and treatment services for children and adults with disabilities. S ome of these services include such things as health screenings, therapies, behavioral support services, transportation, and home healthcare. Me dical Assistance was authorized on July 1, 1969, under the Social Security Act, Title XIX, Grants to States for Medical Assistance Programs. It is funded partly by the states and partly by the federal government. The code of federal regulations, Title 42, The Public Health and Welfare, is another important source of law that states the federal regulations pertaining to medical assistance. Medic al Assistance is a free program and anyone can apply for Medical Assistance, however, not everyone with disabilities is eligible for Medical Assistance benefits. Each s tate establishes its own eligibility standards, benefits package, provider requirements, payment rates, and program administration under broad federal guidelines. This pa per will provide an overview of Medical Assistance eligibility requirements, services, and the rights of children that are Medical Assistance eligible, ages 3-21.
In order to meet the federal MA qualifications, the child with disabilities must meet the U.S. citizen/alien requirements for MA, fit into one of the categories that MA establishes, and meet income and resource requirements (Pennsylvania Health Law Project, 2003). In order to be MA eligible in Pennsylvania, one must be a resident of the state or a covered immigrant (Pennsylvania Health Law Project, 2003). There are several categories within MA that cover persons with disabilities and they often have different requirements (Pennsylvania Health Law Project, 2003). Children wi th disabilities that are eligible for Social Security Income (SSI) are automatically eligible for MA.
Children wit h disabilities that are categorized as severely disabled and are not on SSI are also eligible for MA, regardless of their parents