A Guide to Your Rights

• An Overview and Introduction
• Health Insurance
• Patient Safety
• Private Benefits:
  Motor Vehicle Insurance
• Private Benefits: Disability Insurance
• Private Benefits: Workers Compensation
• Public Benefits:
  Commonwealth Of Pennsylvania
• Public Benefits:
  Crime Victims Compensation Fund
• Public Benefits:
  Federal Government
• Public Benefits: Attendant Care
• Disabled Children
• Rehabilitation Hospitals
  & Facilities
• Vocational Rehabilitation Services
• Civil Litigation: Claims For Damages
• Resources
• Support Groups
• Entitlements And Benefits
• Acknowledgements

 

Public Benefits:
Commonwealth Of Pennsylvania

Medical Assistance/Medicaid is available to disabled individuals living at the poverty level through the Pennsylvania Department of Welfare. Usually, a hospital or rehabilitation facility will have personnel available to help negotiate the many procedural steps necessary to put this coverage in place.

Medicaid health insurance coverage for disabled adults is subject to income eligibility. In order to be entitled to Medicaid, an injured person must be “disabled,” have a very limited income (less than $739 per month) and very limited resources (less than $2,000 in assets). These eligibility requirements are somewhat different for individuals living with dependent children. Furthermore, workers who have disabilities but are still able to work in a limited capacity, and who are receiving social security benefits, may be able to receive health insurance through the Medical Assistance program, if their assets and income fall below federal poverty levels.

 

Health insurance for children is available through two different sources.

The most common source of insurance coverage for children is through the Childrens Health Insurance Program (“CHIP”). Generally, a family must earn enough that the family is ineligible for medical assistance, but still have a limited income. The income limits vary with family size and the age of the children, and are adjusted from time to time. As of the spring of 2005, a family of 4 could earn up to $38,700 and qualify for free insurance, and could earn up to $45,473 and qualify for subsidized insurance. Pennsylvania Children’s Health Insurance Program can be contacted at (800) 986-KIDS. Additional information, and an on-line application, is available through the Pennsylvania Insurance Department’s website: www.ins.state.pa.us.

State-funded health insurance for disabled children may also be available through the Department of Public Welfare. This coverage applies only to the disabled child and not to other, non-disabled family members. The coverage is available no matter what the parents earn. Personnel at a hospital or rehabilitation facility should be able to help you understand, and work through, the specific requirements for this program.

Medical Assistance through the Commonwealth of Pennsylvania Department of Public Welfare is often provided through private managed care insurance companies. Furthermore, the Department of Public Welfare has its own mechanisms for monitoring and controlling medical care costs. Patients who have insurance through DPW can face many of the same problems with an insurance bureaucracy (such as disagreements about what is medically necessary) that privately insured patients sometimes face. It can raise many of the same problems for seriously and catastrophically injured patients that privately insured patients face.

The Department of Public Welfare also provides a variety of other benefits that may be essential to keep a family on its feet. These include food stamps, energy assistance, and in some instances cash assistance. Because of the tremendous impact a catastrophic injury has on the ability of a patient to survive economically in our society, these may be invaluable, particularly for patients with limited financial means before their injury. Information concerning DPW benefits, eligibility, the application process and the location of local DPW offices can be found at DPW’s website, www.dpw.state.pa.ustop