When a child is born with special needs, becomes ill, or is injured in an accident, families must suddenly deal with hospitals, medical specialists, and insurance technicalities. It is very important for the family to locate medical professionals with whom they can feel comfortable with and communicate effectively.
Below is a list of resources to help you locate medical professionals who have experience working with children with special needs. Past experience can be very useful as the medical professional gets to know your child and your family.
Caring Nurses
100 North Washington Street, Suite 313, Falls Church, VA 22040
Phone: 703-241-0057
Email: caringnurses27@verizon.net
Project MED (Medical Education for Consumers)
Email: info@project-med.org
Web site: www.project-med.org
Alexandria Health Department
Address: 4480 King Street Alexandria, VA 22314
Phone: 703-838-4400
Web site: alexandriava.gov/city/health/
Alexandria Health Department
Child Health Clinic
Address: 4480 King Street Alexandria, VA 22314
Phone: 703-838-4414
Arlington County Department of Health and Human Services
Child Health Clinic
Address: 4480 King Street Alexandria, VA 22314
Phone: 703-838-4414
Fairfax County Health Department
10777 Main StreetFairfax, VA 22030
Phone: 703-246-2411
TTY: 703-591-6435
Web site: www.fairfaxcounty.gov/hd/
Parents who have children with special needs have many responsibilities, including paying health care providers that work with their child get paid. It can be difficult to understand the health care insurance system, so here is an introduction.
There are two basic types of health insurance. The indemnity plan is a plan in which patients can go to any doctor or specialist for services and be reimbursed by their insurance company. A managed care plan can take many forms, such as a health maintenance organization, a preferred provider organization, or a point of service plan. Basically, all managed care plans require individuals to have a primary care physician that is affiliated with the plan. This primary care physician can then refer individuals to specialists, which must also be affiliated with the plan. Individuals who obtain health care from a physician, specialist or hospital that is not a part of the managed care plan network of health providers may have to pay for part or all of the service using their own money. Many insurance plans will require prior authorization for services. This means the patient must request permission for a service from the insurance company before the service is given. Insurance companies often have case managers, who act as a coordinator of a child’s and family’s health services, and work with the family and other service providers. Case managers can also help families who have been denied services with filing appeals, or written protests regarding the insurance company’s decision about health care services.
Health care financing is complicated, and can involve many hidden fees. Most health plans charge an annual premium. Employers that provide health insurance benefits may pay part or all of the premium. Some plans charge a deductible, which is a percentage or dollar amount of money you must pay for a service each year before the insurance company begins to pay. Many health plans require a copayment or copay for certain services each time you receive the service (e.g., $5 for a physician’s visit, $10 for a specialist visit, $10 for medication, $50 for a hospital visit, etc.).
A wide variety of arrangements for financing health care is available in both the private and the public sector. Success in paying for the comprehensive medical services your child needs may come from a combination of the following private and public resources.
Fairfax County Health Department
Medical Care for Children Partnership (MCCP)
12000 Government Center Parkway, Suite 432 Fairfax, VA 22035
Phone: 703-324-5171
TTY: 711
Fax: 703-222-9198
Web site: www.fairfaxcounty.gov
Virginia Department Of Medical Assistance Services
Waiver Services
600 East Broad Street, Richmond, Virginia 23219
Phone: 804-786-1465
TTY: 800-343-0634
E-mail: DMAS-Info@dmas.virginia.gov
Virginia Department Of Medical Assistance Services
Health Insurance Premium Payment (HIPP) Program
600 East Broad Street, Richmond, Virginia 23219
Phone: 804-786-1465
TTY: 800-343-0634
E-mail: DMAS-Info@dmas.virginia.gov
Web site: www.dmas.virginia.gov
Arlington Department of Human Services
Financial Assistance
3033 Wilson Blvd.Suite 700-A Arlington, Virginia 22201
Phone: 703-228-1350
TTY: 703-228-1788
E-mail: DMAS-Info@dmas.virginia.gov
Web site: www.arlingtonva.us
Alexandria Department of Social Services
301 King Street, Alexandria, VA 22314
Phone: 703-838-0700
Web site: alexandriava.gov/dhs/
Fairfax County Department of Family Services
12011 Government Center Parkway Fairfax, VA 22035
Phone: 703-324-7800
Fax: 703-222-9452
Web site: www.fairfaxcounty.gov/dfs/
Medicine Program
Phone: 573-778-1118
Web site: www.themedicineprogram.com
