I don't know if it was "first-time Mommy ignorance" or just "never needed it so never needed to know", but when Olivia came home in July 2013 and we had our visit to the International Adoption Clinic (IAC) at Nationwide Children's Hospital here in Ohio, I learned of an unexpected treasure, a gift to moms, dads, and families of children with ongoing medical challenges.
In Ohio, it is called the "Bureau of Children with Medical Handicaps", or BCMH for short. Falling within the Ohio Department of Health, it is funded from the federal Maternal and Child Health Block Grant, state general revenue funds, county tax funds, third-party reimbursements, and donations. The mission of BCMH is "to assure, through the development and support of high quality, coordinated systems, that children with special health care needs and their families obtain comprehensive care and services that are family centered, community based and culturally sensitive."
Translate?
They want to help make medical care for our kids easier and help pay for it.
For us, it started at the IAC. We did a little bit of paperwork (less than 5 minutes). The doctor filled in some more information and they sent it in. We received some more paperwork from BCMH asking for deeper details. We waited. And then received our approval letter. At each of our specialists, we complete the brief application (the detailed one only happens once). And then we wait and then we are approved.
What does "approved" mean? For any of the doctors, treatments, procedures, etc. for which we now have approval, once the medical bill has been sent through our personal insurance, BCMH will pay 100% of the remaining balance. 100%!! As long as we see each of the specialists at least once in the calendar year, Olivia's coverage will remain intact until she is 18.
The hardest part of this entire process - which I should have been prepared for having travelled the adoption journey - was the waiting. I was advised not to pay any of the medical bills while I was waiting for BCMH approval. This meant that statements came, sometimes saying "final notice" and I had to just set them to the side. This was not easy. I'd call the billing department let them know that our approval was pending, and they'd reset the notification so I wouldn't show up delinquent. (I've worked really hard to have good credit, so this part of the process was really uncomfortable!)
BCMH also has assigned us a liaison who came to our house, sat down, went through paperwork and questions with me. She has already been an asset to us - there was a hang-up with one of the application revisions. I was able to shoot her an email and she was able to log right into their system and begin pursuing the appropriate people to get it resolved.
A couple of things to note:
- As would be expected, coverage is not for care that has happened in the past, but does include care/treatment while approval is pending, so don't wait to start the paperwork.
- It does not include visits to your pediatrician -- whether well or sick visits.
I have been told by a fellow adoptive mom who works for the Ohio Department of Health that any state who receives funding from the federal Maternal and Child Health Block Grant will have a similar program. It is important to note that like BCMH, most programs are going to have some type of qualifications, paperwork, etc. so all may not share the exact same experience as we have.
I'm sure that each state has its own caveats as to how their programs are run, but if you have a child (or children) who live with ongoing medical concerns, I highly recommend you look into this resource that is available to you. As I said at the beginning, I didn't know anything about it, but boy am I glad that I now do! In just the last 9 months we have had appointments, 2 surgeries, hospital stays, follow-up visits, x-rays, infusions, and more ALL COVERED!
As links to different state programs/resources are shared with me, I will work to add them here. If you have one, let me know!
Indiana - http://www.state.in.us/isdh/19613.htm
South Carolina - TEFRA (see below) administers their program. Contact the following for assistance: Family Connection. www.FamilyConnectionSC.org
Another program that was shared with me (but is not available to us in Ohio) is called "TEFRA". Here is the link so that you can learn more and find out if it will be a valuable resource to your family:
http://hdwg.org/catalyst/cover-more-kids/tefra
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