» Hook Law Center Special Needs Attorney Explains Obamacare’s Impact on Special Needs Families

Hook Law Center Special Needs Attorney Explains Obamacare’s Impact on Special Needs Families

Virginia Beach, VA (Law Firm Newswire) February 28, 2014 – A part of the Affordable Care Act (ACA) expands treatment for people with developmental disabilities, but some states may leave insurers with ways to sidestep the new requirement.

Hook Law Center (formerly Oast & Hook)

Hook Law Center (formerly Oast & Hook)

The ACA, commonly called “Obamacare,” requires health insurance plans for individuals and small groups to include coverage for “rehabilitative and habilitative services and devices.” Most insurance plans already cover rehabilitative services, which help people regain skills, such as walking or talking, after a debilitating injury or illness, such as a stroke.

“But habilitative services are often excluded,” explains Virginia special needs attorney Andrew Hook. “These services help people learn or maintain skills — as opposed to regaining them. They are crucial for individuals with autism, cerebral palsy and similar disabilities, and prior to the ACA, insurers rarely covered them. They would classify these disabilities as educational issues as opposed to medical issues.”

But advocates fear insurers in many states will still find ways to avoid or minimize coverage for habilitative services. The Department of Health and Human Services (HHS) permits insurers and state governments to decide the scope of the habilitative services that must be covered.

Each state is required to identify a “benchmark plan” to form a basis for defining the benefits that insurers will be required to offer. HHS rules say that if the benchmark plan does not define habilitative benefits, a state may choose to set that definition separately. If a state chooses not to set such a definition, it may either require insurers to cover habilitative services to the same degree as rehabilitative services, or it may leave insurers to set those limits themselves.

So far, fewer than half of states have explicitly defined the scope of habilitative services or elected to require parity with rehabilitative services, sparking the concern of special needs advocates. Moreover, past insurance shoppers have often had difficulty determining the specifics of habilitative coverage using the summary of benefits that insurers publish online. The changes may leave shoppers with even more opaque information.

Hook pointed out that private insurance is not always the best option for special needs families.

“Medicaid covers comprehensive habilitative services for enrolled children,” he says. “Parents who wish to know the specifics of qualifying for and enrolling in Medicaid should consult an experienced special needs attorney.”

Hook Law Center
295 Bendix Road, Suite 170
Virginia Beach, Virginia 23452-1294
Phone: 757-399-7506
Fax: 757-397-1267

SUFFOLK
5806 Harbour View Blvd.
Suite 203
Suffolk VA 23435
Phone: 757-399-7506
Fax: 757-397-1267
http://www.hooklawcenter.com/

  • Understanding the stages of Alzheimer’s
    Reportedly, over five million Americans are afflicted with Alzheimer’s. The Alzheimer’s Association has created a checklist of the usual symptoms to help you identify the warning signs. Among these are changes in memory that interfere with daily life, difficulty planning and resolving problems, becoming disoriented regarding time and place and having issues with words when […]
  • Transportation is an often overlooked but crucial aspect of retirement planning
    When people engage in retirement planning, they often fail to think about transportation. They do not consider that a time may come when they will no longer be able to drive themselves, and will have to rely on others to go to doctors’ appointments and run errands. Including transportation in your retirement plan is essential. […]
  • How caregivers can deal with behavioral changes of loved ones with dementia
    There is ample research to suggest that family caregivers are more distressed by behavioral problems and changes in the personality of their loved ones than by their physical disabilities. For instance, while it may prove challenging for family members to physically pick up the body of a loved one who has suffered a stroke and […]
  • Financial elder abuse may be fastest growing type of crime in U.S.
    Financial elder abuse has been described as the fastest growing type of crime in the U.S. To avoid having this happen with your senior loved one, it is important to be aware of the dangers. A study conducted by the Journal of General Internal Medicine revealed that 60 percent of the Adult Protective Services (APS) […]
  • How caregivers can deal with behavioral changes of loved ones with dementia
    There is ample research to suggest that family caregivers are more distressed by behavioral problems and changes in the personality of their loved ones than by their physical disabilities. For instance, while it may prove challenging for family members to physically pick up the body of a loved one who has suffered a stroke and […]

See other news sources publishing this article. BETA | Tags: , , , , ,



Get headlines from Law Firm Newswire sent right to your inbox.

* indicates required