Medicaid covers more than what they tell parents and patients. I made this discovery a few years ago. N is on pedicure for weight gain. J is on pedicure because sometimes she cannot eat due to stomach issues.
Pediasure
We were worried about N not gaining enough weight and because of how tiny he was. The doctor suggested pediasure. I called the durable medical provider. I asked them if they provide pediasure and if they are covered by medicaid. They told me its just a prescription. No prior authorization like is needed for diabetes insulin pump supplies. It was that easy. The prescription just needs to be resubmitted once per year.
Incontience Supplies
So pull-ups, diapers, etc are a little more tricky but not too bad. Medicaid will only cover this if the child is 4 years of age or older, has a related diagnosis or receives speech/occupational/physical therapy. For N it was easy because he has VUR, A is a diabetic, D has environmental delay (a type of delay that is caused by a neglectful environment but that was from before we got him), etc.
Some durable medical equipment providers have their own form that the doctor has to fill out to act as a prescription. That you need to find out for your local durable medical equipment provider.
There is one that just does incontinence supplies for all 50 states called active style. They aren’t paying me for this, we have just used them in the past. Once they receive the prescription, they will call and ask questions about the person who needs the supplies. They had us take measurements of the kids using a tape measure, so make sure you have one.
For this a prior authorization is needed, so keep that in mind when starting the process. For us these prior authorizations take a few days to a week.
I hope you find this helpful. If you do not know which durable medical provider is covered by your medicaid plan, call them and they will tell you. Don’t tell them what it is for otherwise they may not tell you.
Weighted Vest
Yes a weighted vest is covered by medicaid too. The same process is used as the incontience supplies. They will need notes from the OT working with the child.
Fierce Autie 