» 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/

  • Problematic Proposed Regulations May Harm Family Businesses If Left Unaddressed
    This newsletter recently addressed proposed treasury regulations that, if enacted, will drastically impact transfers of family businesses. The hearings on the proposed regulations (the “2704 Regulations”) were held this month, and those participating were extremely critical of the proposed regulations. According to a Forbes.com report, only 1 of the 36 people who testified at the […]
  • Decanting an Irrevocable Trust to Protect Public Benefit Eligibility
    Unintended consequences can occur when people fail to consider the effect of a plan on persons with special needs. Estate planners who are unfamiliar with public benefits may unintentionally create plans that can wreck a beneficiary’s eligibility for SSI, Medicaid and other means-tested public benefits, resulting in a loss of income, healthcare coverage, housing, etc. […]
  • ‘Tis the Season…for hospital admissions and long-term care planning!
    Author: Stephanie Washington Co-Author: Letha Sgritta-McDowell During the holidays, it is not uncommon for emergency rooms to see an increase in visits by the elderly population. As we know, the elderly are more susceptible to catching pneumonia due to their waning immune systems, falling due to lower body weakness and poor balance, combined with vision […]
  • Life-Saving Tech Tip for Cell Phone Users
    Your cell phone may have a life-saving feature that you should be aware of. For iPhone users, the feature is called “Medical ID.”  Medical ID lets others access important medical information about you without unlocking your phone.  From the “unlock” screen, a first responder can tap the “Emergency” option in the bottom left corner, then […]
  • What President-Elect Trump and the Republican Party have in Store for You: Estate, Gift and Generation Skipping Transfer Taxes
    Well, one of the more painful election cycles I have ever experienced is, thankfully, over. Now that the American people have finally cast their votes and elected Donald Trump to the White House and a Republican-controlled Congress, it is natural to wonder what changes, if any, you can expect. Certainly, a lot of promises have […]

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



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

* indicates required