Hey there, parent. You’re juggling a lot, especially regarding your neurodivergent child. You’re their advocate, their cheerleader, their rock. But when it comes to figuring out healthcare and support services, it can feel like you’re lost in a maze. That’s where “west virginia Medicaid” waivers come in. This guide will help you understand, apply for, and maximize these waivers. So, grab that cup of coffee, and let’s tackle this together.
Before diving into the nitty-gritty, let’s clarify Medicaid waivers. They’re a financial safety net for families with kids with thinking and learning differences. But they’re not handed out like candy at a parade. You have to apply, and eligibility is based on specific criteria.
Here’s the good news: West Virginia Medicaid looks at the income and resources of the child, not the parents, for these waivers. Your child could qualify even if your family income exceeds the Medicaid limit. But there’s more to it. Your child must have a diagnosed condition that requires a level of care typically provided in a hospital or nursing facility. Plus, they must be able to receive safe and effective care at home or in the community.
Like there’s more than one way to peel an apple, there’s more than one type of Medicaid waiver. The Intellectual/Developmental Disabilities Waiver (IDDW) is for children with severe intellectual disabilities or specific related conditions. On the other hand, the Aged and Disabled Waiver (ADW) is for older adults and people with physical disabilities, including neurodivergent kids.
It’s all about finding the right fit for your child. And don’t worry, you’re not alone in this. Organizations like Goally are here to help you navigate these waters.
Alright, you’ve figured out your child may be eligible. What’s next? The application process for Medicaid waivers in West Virginia can seem as daunting as climbing a mountain. But we’re here to break it down into manageable steps.
Waiver #1: Children with Disabilities Community Service Program (also known as TEFRA)
First off, start early. The waiting list for waivers can be long, so it’s best to get the ball rolling as soon as possible. Next, gather all necessary documents. This includes medical records, proof of income, and a letter from your child’s doctor confirming the need for home and community-based services. Then, complete the application form. It is on the West Virginia Department of Health and Human Resources website. Request a form by mail or apply in person at your local DHHR office. After you’ve submitted your application, a case manager will assess your child’s needs and eligibility.
Waiver #2: Intellectual and Developmental Disabilities Waiver
So, you’ve secured a Medicaid waiver. Now, it’s time to understand how to make the most of it. Waivers can cover various services, from personal care and respite for caregivers to adaptive equipment and home modifications. But that’s not all. They can also fund services that support your child’s learning and development, like occupational therapy, speech therapy, and behavioral health services.
For instance, Goally’s learning tablet for kids can be a game-changer for your child’s development. It’s explicitly designed for neurodivergent kids, making learning interactive and fun.
| Criteria | Score (out of 5) |
|---|---|
| Website clarity and ease of navigation | 0 |
| Access and requirements of qualification | 2 |
| Healthcare coverage | 3 |
A guide to accessing services in West Virginia.
Find specialized services providers for autism near you using this map
West Virginia Parent Training and Information Inc
Contact West Virginia for Medicaid Services at (304) 558-1700 for a good place to get started on this process.
Remember, you’re not alone in this journey. There are resources out there to guide and support you. For example, the West Virginia Family Support Program offers assistance with navigating the Medicaid system. And remember the power of community. Advocacy groups and online communities can provide invaluable advice and emotional support.
In the end, securing a Medicaid waiver may seem like a steep climb, but it’s a journey worth taking. With patience, persistence, and the right information, you can unlock a world of support for your neurodivergent child. Because every child deserves the chance to thrive, and as parents, we’ll do whatever it takes to make that happen.
Does your child need some extra guidance on building essential life skills? Goally’s skill building tablet for kids includes a TV app that has the most robust video library of skills training videos for kids. Ranging from content like “How to Brush Your Teeth” to “How to Make Friends at School,” we have dozens of interactive video lessons for kids with thinking and learning differences.
HERE’s a video explaining how to works.
Circumstances/Diagnosis: Any child under 19 who is diagnosed with any type of severe disability. This includes intellectual and/or developmental disability like autism. The state requires that individuals need at least an intermediate care facility level of care to qualify. This has a technical definition but 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.
The way TEFRA waivers work is that they allow families with higher incomes to receive medicaid benefits for their child because eligibility is based on the child income. This means that you will be able to receive dental care, emergency and non-emergency transportation, inpatient and outpatient treatment, medical equipment, occupational therapy, pharmacy, physical therapy, vision and in some states ABA therapy.
Contact the program office at 304-776-7230
Contact the Program Manager at (304) 356-4853
Same eligibility requirements as above but the only disabilities permitted are intellectual and developmental ones and people of all ages can apply.
West Virginia’s website is comically bad. It lacks almost all relevant information and just provides a number to call.
Additionally West Virginia has a waiting list of around 1000 people but we are unsure how long it takes to get off of it. The waitlist has formed in the past few years due to budget cuts to the program. The governor has recently stated that he wanted to eliminate the waitlist but it seems that the program has not received the $19 million it would need to do so.
This post was originally published on 02/16/2021. It was updated on 09/14/2023.
