Parent Question & Answer Regarding School-Based Medicaid

What is Medicaid?
Medicaid is a joint federal and state program that provides health insurance coverage for eligible students.

How do Medicaid and schools work together?
Medicaid School-Based Services is a federal-state program that helps school districts by allowing them to receive reimbursement for medical services provided to Medicaid eligible students with disabilities, as documented on the child’s Individualized Educational Program (IEP). School districts frequently utilize this Medicaid reimbursement to help offset the costs of providing medically necessary special education services.

Which students can the district submit Medicaid claims for?
Schools can provide medical services to all students based on needs. Currently, school districts can only receive reimbursement to offset the costs of providing those services to Medicaid eligible students with disabilities.

What services does Medicaid cover?
Medicaid reimburses district for services such as Occupational Therapy, Physical Therapy, Nursing Services, Speech/Language Services, and Social Work Services. Additional services may be covered under your state Medicaid plan.

What are the benefits to my child’s school?
Public schools incur costs when providing health related services to students who are Medicaid eligible. The salaries of providers (such as Nurses, Physical Therapists, and Speech and Language Pathologists) are just some examples of the costs incurred by public schools. The ability to pursue Medicaid reimbursement helps schools to offset costs associated with providing health services.

How do I help my child’s school get Medicaid reimbursement?
To help your child’s school recoup some of the costs of providing medical services, you can enroll your child in Medicaid and provide signed consent to your child’s school. Federal special education law requires school districts to seek parental consent prior to submitting claims for reimbursement from public insurers such as Medicaid.

What are the benefits to enrolling my child in Medicaid?
Medicaid provides access to quality health care options, such as regular check ups and immunizations, and covers costs for prescriptions, therapies, and vision/dental care.

What if I do not grant consent for the school to bill Medicaid?—or—What if I change my mind?
You have the right to deny or withdraw consent at anytime. Your child’s free and appropriate public education and related services will continue with or without consent.

Are there any negative effects to enrolling my child in Medicaid?
No, there are no negative effects to enrolling your child in Medicaid. Services provided to a student within a school setting are provided at no cost to the parent/guardian. Additionally, granting permission for the school district to bill Medicaid will not reduce your ability to seek other Medicaid-covered health related services outside of the school setting. This permission does not decrease lifetime coverage, increase premiums, or lead to the discontinuation of benefits, as Medicaid does not have a maximum number of eligible visits or a lifetime maximum for services.

Who will see my child's Medicaid information?
Your child’s demographic and service information will be shared with the state Medicaid Agency for the purpose of verifying Medicaid eligibility and submitting claims.

How do I enroll my child in Medicaid?
Enrolling your child in Medicaid is easy! Visit your state Medicaid website or contact your primary care physician. To find a local office for help in enrolling in Medicaid, visit widget.getcoveredamerica.org/ or calling toll free at (866) 311-1119 with any questions.

Subscribe Here!

Ready for a Quick 5 Minute Conversation?