Will my adopted baby with Down Syndrome qualify for Medicaid?

Question

My husband and I are considering adopting a baby boy with Down Syndrome. Our insurance has already told us he would be denied. So before we can move forward, we need solid information about whether or not he will qualify for Medicaid. If so, what exactly does medicaid cover and at what percentage?

Thanks to anyone who can help,

Erin

Answer 1

Yes they will qualify for medicaid as it is a dibiitating illness with no hope of recovery.

They will also qualify for social security disability.

I don't know where you live, but I would contact your child welfare office as well as consult a lawyer in family affairs to get the specific answers you need.

A consultation usually cost nothing with an attorney and your DHR and health dept are free.

Good luck, hope this helps.  Jackie b

Answer 2

I don't think that just because  child is born with Down Syndrome they qualify for medicaid.  You should talk to your insurance agent about that, or your family doctor.  they should know.

Answer 3

Are you and your husband self-employed, with your own health insurance policy?  Or are you employed by a company with group insurance?  Because a group insurance carrier CAN NOT refuse to provide coverage for an adopted child with a pre-existing condition.....it's the law!!  I can tell you this from experience, because I adopted a 10-year-old with a congenital heart condition, and a 4-year-old with chronic Hepatitis B and hearing impairment.   They were fully covered from the date the adoption became legal.

However, I do know that if you have independent insurance that you pay for yourself, they are permitted to deny your child coverage.   If that is the case, you may want to talk to your social worker about available health insurance through your state.  Our state (Connecticut) offers the "Husky" policy for uninsured children.

Answer 4

I have an adopted brother who was drug addicted when he was born. That is considered a disability and In AZ where we live he get money every month for being adopted. its called adoption subsidy. My moms income if far to high to qualify for food stamps but he still get them because he is adopted. he also get free insurance until he is 18 or 21 if he is in school he get free day care and They will pay for his collage. he is very well taken car of also 2x a year he gets a clothing allowance. Also you are a strong and great person, for adopting

Answer 5

Check with your agency first and foremost.  They can tell you what is available to you and, if it was me, I'd get it in writing.  Many adoption systems make provisions for the medical care of an adopted child if the care is over and above what insurance or socialized medicine will cover.

Answer 6

It depends on which state you live in, but MOST states offer a Medicaid type coverage for children that is EXTREMELY easy to get (as long as you do not have medical coverage). It really shouldn't be a problem I'd imagine.

Congrats & best of luck to you, That is a VERY unselfish move on your part.

Answer 7

It depends on what State you live in. Here in Texas, you are eligible for Medicaid (its called TP21-Adoption Subsidy). In addition to that the child should also qualify for Supplemental Security Income for the disability which automatically comes with Medicaid. I would suggest you contact some support groups in your area for more information. Best of luck.

Answer 8

hi erin...medicaid will cover your adoptive son at 100%. it will cover health, vision, and dental. it will also cover therapies that are so important.  there are many programs available for children with down syndrome. early intervention (or it is called birth to 3) is crucial for conquering developmental delays they offer physical therapy, occupational therapy, and speech therapy along with special education. when you talk to a case worker ask to set up an appointment with the early intervention people. then there is supplemental social security and if your son is delayed 30% or more and you are within the income level he would receive a SS check from both the federal government and the state (he would automatically get medicaid for that too). each state also has programs that would help finanacially for things that your son would need...special toys, special fun classes such as horse back riding lessons, and so on...but the waiting list for these types of services is long...in some cases 8-10 yrs. so you would want to get on a waiting list for these right away.  if you have any more questions please feel to email me at anytime!

julie