Medicaid and Insurance
Medicaid Benefits for Children with Down Syndrome
STOP! Don’t pay your baby’s hospital bill yet!
Chances are you may already have medical insurance or plans to pay for your baby’s hospital bill out of your own pocket. Even if you have great insurance, you will want to consider applying for Disabled Child Living at Home through the Division of Medicaid as a supplement to your private insurance. With proper documentation and paperwork filled out providing disability details, children with Down syndrome should qualify.
DD (Developmental Disability) Medicaid Waiver
If your child qualifies for Medicaid for Disabled Child Living at Home program, you are eligible to apply for the DD Medicaid Waiver program. The wait list is long, but the benefits provided are worth the wait. Don’t delay – get on the list today! This program provides an approved number of hours of attendant care or respite care free of charge in your home to allow you to work or have a time of respite. You can select a caregiver you know and trust with your child. The DD Waiver can also provide Community Care, which would provide free care for your child at a Medicaid-approved facility.
Contact Information for the DD Medicaid Waiver Program:
- Hudspeth Regional Center serves most Central Mississippi counties — (601) 664-6170
- Ellisville State School serves most South-Central Mississippi counties — (601) 477- 5887
Apply for Medicaid Benefits
Those approved through the Mississippi Department of Medicaid for Disabled Child Living at Home can expect that Medicaid will go back for three months and pay most or all medical bills incurred on behalf of your child, including their portion of the hospital bill at birth. Notify the billing departments of your hospital and doctors to let them know that you are applying for Medicaid. If you go ahead and pay, it may be difficult or impossible to get reimbursed by Medicaid. Medicaid will pay for a variety of items and services that may not be included in your insurance plan. Even with a great insurance plan, you will have co pays, prescriptions, deductibles, and limits on therapeutic services, etc. Medicaid will likely cover what your insurance doesn’t cover. Medicaid will provide diapers if your child needs them after the age of three. It is worth the time investment to fill out the paperwork.
Tips for Applying:
- Instead of “Down syndrome” Medicaid prefers “Trisomy 21” as the diagnosis.
- Provide documentation of a history/physical exam completed within the last 12 months including the frequency, duration, and cause of inpatient hospitalizations and emergency room visits.
- Medical records from any treating provider (physician, therapist, etc.) with examples of observed tasks that demonstrate or support the existing level of functioning as it relates to the child’s need for assistance with age appropriate activities of daily living and the need for care in an institution.
- Parents may provide examples of a child’s routine schedule, which documents the type of intensive care
required to actually care for the child’s daily needs.
- Please include any specialized parent training in the past 12 months specifically related to the care of the child’s medical condition, i.e., training in CPR, glucose monitoring, suctioning, behavior modification, etc.
Other details that may be appropriate should be listed (ex. low tone, any heart defects, feeding issues, etc.)
If Medicaid does not initially approve your child, try again! Contact us for advice on appeal.
The Disabled Child Living at Home Program is NOT based on your income level; it is based on your child’s disability. If Medicaid does not initially approve your child, try again! Your child may qualify on appeal, even if an evaluation is needed. For evaluation options, visit the Early Intervention page.
Contact CMDSS for advice on appeal.
Mississippi Medicaid Regional Offices
Medicaid Regional Office locations can be found on the Department of Medicaid website: medicaid.ms.gov, scroll down and click on the paragraph underneath Medicaid Office Locations. Below is a partial list of counties:
Rankin, Simpson, Smith
Brandon Regional Office
3035 Greenfield Road,
Pearl, MS 39208
Copiah, Lawrence, Lincoln
Brookhaven Regional Office
1372 Johnny Johnson Drive
Brookhaven, MS 39601
Covington, Jeff Davis, Marion
Columbia Regional Office
501 Eagle Day Avenue, Suite A,
Columbia, MS 39429
Forrest, Lamar, Perry
Hattiesburg Regional Office
6971 Lincoln Road Extension
Hattiesburg, MS 39402
Jackson Regional Office
5360 I-55 North
Jackson, MS 39211
Attala, Choctaw, Leake
Kosciusko Regional Office
160 Highway 12 West
Kosciusko, MS 39090
Greene, Jones, Wayne
Laurel Regional Office
1100 Hillcrest Drive
Laurel, MS 39440-4731
Meridian Regional Office
3848 Old Highway 45 North
Meridian, MS 39301-1517
Jasper, Newton, Scott
Newton Regional Office
9423 Eastside Drive Extension
Newton, MS 39345-8063
Kemper, Neshoba, Noxubee, Winston
Philadelphia Regional Office
340 West Main Street
Philadelphia, MS 39350
Claiborne, Issaquena, Sharkey, Warren
Vicksburg Regional Office
3401 Halls Ferry Road, Suite 1
Vicksburg MS 39180
Holmes, Humphreys, Yazoo
Yazoo City Regional Office
110 North Jerry Clower Boulevard, Suite A
Yazoo City, MS 39194