Family SHADE

Enable. Empower. Enrich.

Enable. Empower. Enrich.

Health Care/Insurance

Here you will find information about insurance, Health care, and Mental/Behavioral health

The first stop on your journey is often your primary care physician or your child’s pediatrician. Your doctor is an integral partner in your care. This relationship is too important for you to settle for a doctor if it appears that she will impede your ability to seek out answers and take an active role in your child’s care. Trust your instincts and look for a new doctor if you feel your doctor cannot provide everything you need.

A Medical Home/ The Doctor’s Office
  • A family-centered medical home is not a building, house, hospital or home health care service; it is an approach to providing comprehensive primary care. In a family-centered medical home the pediatric care team works in partnership with a child and the child’s family to assure that all of the medical and non-medical needs are met.
  • The primary care doctor or pediatrician is easy to reach by phone, will work with your specialists, provides you with clear instructions and written materials when asked and will help with the coordination of appointments with specialists and any tests or lab work needed.

Doctors and their staff are responsible for completing paperwork for medical equipment and services. They will inform insurance companies and agencies about any equipment, medical supplies, therapies, nursing visits or other home care you need. Written prescriptions also are provided by the doctor’s office. It is very important to communicate effectively with your doctor so she can get a clear picture of what you need.

Insurance

Find out what public or private insurance coverage you have or are eligible for, including employer- related coverage, Medicaid and Medicare, and the type of benefits your insurance covers. Ask if it pays for speech therapy, physical therapy, occupational therapy, home care, durable medical equipment and assistive technology, nursing visits, mental health services, dental services and the supports your physicians, therapists and specialists have said you will need. Also ask if the services require prior authorization and how the process works to obtain approval.