Parenting a neurodivergent child is like being a ship’s captain, navigating calm and stormy seas. Sometimes, you need a lighthouse to guide you, and that’s where the North Carolina Medicaid Waiver comes in. This program can be your beacon, providing financial assistance for services that greatly enhance your child’s life. Let’s unravel the mystery of the North Carolina Medicaid system and discover how to secure a waiver.
North Carolina Medicaid, a joint state and federal program, is designed to assist low-income individuals and families with healthcare costs. For parents of neurodivergent kids, it’s not just a financial aid program; it’s a lifeline. But to truly harness its power, you must understand the available waivers.
These waivers are special programs that provide additional services to specific groups of individuals. In North Carolina, there are three main waivers that you should know about:
Eligibility for a North Carolina Medicaid waiver is like a puzzle, with several pieces that must fit together. These pieces include factors like income, age, and level of care required. But, most importantly, your child’s condition must be severe enough to require the level of care typically provided in a hospital, nursing facility, or intermediate care facility for individuals with intellectual disabilities.
Read more: ABA Therapy in North Carolina
For example, if your child has a severe intellectual disability that requires round-the-clock care, they may be eligible for the Innovations Waiver. On the other hand, if your child has a physical disability that requires a high level of medical care, they may be eligible for the CAP/C waiver. It’s all about matching your child’s needs with the proper waiver.
Applying for a North Carolina Medicaid waiver can feel like charting a course through unfamiliar waters. But with the correct map, you can navigate this process with confidence. Here’s a step-by-step guide to help you chart your course:
| Criteria | Score (out of 5) |
|---|---|
| Website clarity and ease of navigation | 3 |
| Access and requirements of qualification | 0 |
| Healthcare coverage | 3 |
Autism Society of North Carolina can connect you with services like respite, after-school programs, and behavioral interventions and is set up to take payments from health insurance and medicaid
The ARC of North Carolina works through education, research and advocacy to improve the quality of life for children and adults with intellectual disability and their families
NC Child does great policy pushes and advocacy for families needs
Waiver #1: Innovations Waiver
Division of Mental Health, Developmental Disabilities and Substance Abuse Services Customer Service has great information on the waiver process: 855-262-1946
NC Medicaid Contact Centere — 888-245-0179
Securing a North Carolina Medicaid waiver is a significant milestone, but it’s just the beginning. To truly make the most of this lifeline, you must understand how to maximize its benefits. For instance, it’s crucial to maintain open lines of communication with your child’s healthcare providers and the Medicaid staff. Stay informed about any changes in the program and how they might impact your child’s care. Above all, remember that you are your child’s strongest advocate.
One way to maximize the benefits of your waiver is to utilize services like Goally. Our learning tablets and apps are designed to support your child’s unique learning needs, making everyday tasks more manageable. By integrating Goally into your child’s routine, you can enhance the benefits provided by your Medicaid waiver.
At Goally, we understand the unique challenges faced by parents of neurodivergent kids. That’s why we’ve created tools designed to support your child’s unique learning needs. Our learning tablets and apps can make everyday tasks more manageable and enjoyable for your child. But we’re not just about technology. We’re also here to provide resources and support to help you navigate your journey, including understanding and making the most of programs like North Carolina Medicaid.
Goally’s distraction-free kid’s tablet can be used as a therapy tool to help teach executive function, language, emotional regulation, finger dexterity skills, and more!
In short, securing a North Carolina Medicaid waiver can open doors to essential services for your child. It’s not just about financial assistance; it’s about ensuring your child can access the services they need to thrive. With this guide, you’re better equipped to navigate the North Carolina Medicaid system and secure your family’s lifeline. Remember, you’re not alone on this journey. Resources and support, like Goally, are available to help you every step of the way.
Circumstances/Diagnosis: Any child or adult who is diagnosed with either an intellectual and/or developmental disability (this includes autism). The state requires that individuals need an intermediate care facility level of care to qualify. There is a technical definition for this but it essentially just means that the individual is unable to get through their day without a lot of supervision.
Income: Income eligibility is only based on the child’s income and not the parents income. This means that your child is financially eligible for the waiver if they don’t have an income.
You can view the full list of services from assistive technology, community supports, respite, and more HERE
Call your local managed care organization in order to start the application process
North Carolina has a huge waitlist (7-10 years) which is negatively impacting families. Check out this great article detailing what a huge problem this has been for families. This lack of resources is totally unacceptable and needs to be changed. It is still a good idea to get on this waiver though because your child could receive supports for life with the program.
This post was originally published on 02/16/2021. It was updated on 09/14/2023.
