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| Milestone Consulting, LLC

Smiling Baby With PacifierRaising a child who was born with birth defects can be a significant challenge, both emotionally and financially. You want the best long-term medical care for your child. Their needs are the priority, but adequately meeting those needs can be a real financial strain, if not a fiscal disaster.

With healthcare costs rising, it’s no surprise that families who care for children with severe disabilities often struggle to make ends meet. Thankfully, there are a number of government programs that can help.

Government Assistance Programs

Most families who need help paying for healthcare turn to government assistance first, before looking into the programs operated by non-profit organizations. To get started, your best bet is at, where you can learn about the government-run healthcare assistance programs for children that are available in your state.

Health Insurance: Medicaid & CHIP

Two programs, in particular, are especially helpful for children born with birth defects: Medicaid and CHIP. Both government programs provide health insurance coverage for eligible children, which usually lasts until the child’s 19th birthday.

Medicaid is the first line of defense in our nation’s social safety net, providing medical benefits to low-income adults and children who are uninsured or under-insured. To learn if your child is eligible for Medicaid, visit your state’s Health Insurance Marketplace or, if your state doesn’t have its own Marketplace, go straight to No matter your state, the federal government requires that all Medicaid programs cover certain basic health services:

  • Inpatient and outpatient hospital services
  • Physician services
  • Nursing facility services
  • Laboratory and X-ray fees
  • Home health services
  • Certified pediatric and family nurse practitioner services
  • Transportation to and from medical care

States can also elect to cover a broader range of services through their Medicaid programs, including:

  • Prescription drugs
  • Physical and occupational therapy
  • Intermediate care facility services for persons with intellectual disabilities
  • Speech, hearing and language disorder services

For a full list of the mandatory and optional services that may be covered by your state’s Medicaid program, click here.

Your state’s Health Insurance Marketplace is a good place to start your search, even if your child does not qualify for Medicaid. Your may be eligible to have private insurance premiums reduced through a state-administered program.

The Children’s Health Insurance Program

The Children’s Health Insurance Program (CHIP) was designed to help families who fall between traditional public programs and private health insurance options. When lower-income children are ineligible for Medicaid, but private insurance is too expensive, CHIP may be able to pick up the slack.

CHIP is financed by federal and state governments, but the funds are administered by individual states. Thus eligibility requirements vary by state, but most states, along with the District of Columbia, cover children whose families are at or above 200% of the Federal Poverty Line, which is currently $24,300 for a family of four and $20,160 for a family of three.

You can learn more about applying for CHIP through your state’s Health Insurance Marketplace or the federal Marketplace.

Social Security Income

Healthcare is far from the only financial burden that families will have to bear in caring for their child. The Social Security Administration runs many benefit programs. Supplemental Security Income, or SSI, was designed to help people with disabilities meet their basic needs. The program is only available for families with limited income and few assetsIf your family qualifies for SSI, you’ll receive cash that can pay for food, clothing and shelter.

There’s no way to apply for SSI benefits online, at least not completely. One part of the application, the Child Disability Report, can be finished online, but to complete the process, you’ll have to call the Social Security Administration to schedule an appointment. You can learn more about the process at this link.

Exploring The World Of Government Assistance Programs

To learn about your family’s eligibility for a broader array of government benefits, you can visit, and complete the Benefit Finder, a guided form that will evaluate your family’s eligibility for over 1,000 state and federal benefits programs. Simply fill out the form, describing your role as a parent or caregiver and providing applicable details on your child’s condition, and the Benefit Finder will do the rest.

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