Paying for Early Childhood Intervention Services

October 1, 2023

Over three million children in the United States had a reported disability according to the 2019 U.S. Census, and that number has risen 0.4% since 2008. Children experiencing developmental delays, not reaching developmental milestones, or those at risk may be eligible for early intervention services and supports.

When to Screen for Developmental Delays

If a child is born prematurely or with a genetic condition, then that child may qualify for early intervention as soon as birth. Early screening is part of the services that should be offered while parents are in the hospital for their child’s birth. However, if a parent becomes concerned about their child’s development after birth or notices any changes, they should refer their child for an early intervention evaluation. Eligibility for services is based on an evaluation of a child’s skills and abilities. A doctor’s referral is not necessary for an evaluation. It’s important for parents to educate themselves on which milestones their children should be reaching and not rely completely on their doctor’s recommendations; it is parents who spend the most time with their children, so they may notice something that a pediatrician won’t catch during a routine check-up. Emma Fitzsimmons, a New York mom who claims early intervention saved her son’s life, tells other parents, “If you’re worried that your child has delays, I would encourage you to seek out Early Intervention services and to ask for recommendations to find the best therapists in your area and a good service coordinator, the person who oversees your case.”

Know What Your State Offers

If eligible for early intervention, children may receive services to help with physical skills (crawling and walking), cognitive functions (thinking and learning), communication (talking and listening), adaptive skills (eating and dressing), and social-emotional development (play). Services are wide-ranging and can include speech therapy, physical or occupational therapy, psychological services, home visits, nutritional services, audiology (for hearing issues), vision therapy, social work, assistive technology, and even transportation.

The Individuals With Disabilities Education Act, or IDEA, covers early intervention and school-aged services. Under Part C of IDEA, funding is made available to each state and requires services to be made available to eligible children with disabilities. While all states offer early intervention, the screening processes and services offered vary state by state. The first step in finding out what your child may qualify for is learning about what your state offers. The CDC offers links for each state in order to learn about the benefits your state offers. Each state has its own guidelines around how families qualify, but generally, a child must exhibit a developmental delay or have been diagnosed with a specific health condition that is known to lead to delays, such as a genetic disorder. The Early Childhood Technical Assistance Center (or ECTA) also outlines the services each state offers. In some states, children may be eligible for services if they are at risk and not yet exhibiting any delays, such as having been born at a low weight. If a child is found eligible for services, a care team will develop an Individualized Family Service Plan (IFSP), which will outline the services a child will receive and the desired outcomes for those services. For instance, physical therapist Tonya McCool explains, “If a child presents with a delay that limits their abilities to complete age-appropriate milestones, a provider will assist by guiding the child into appropriate positions, providing them opportunities to experience new opportunities or helping them try new things so that their families can continue to work with them throughout the week to meet their goals.”

Who Pays for Early Intervention Services?

Under IDEA Part C, Child Find services, which include the initial referral, evaluations, the development of the IFSP, and service coordination must be made free to families, but depending on your state’s policies, some services may be provided at a cost or on a sliding scale. In addition to the federal education funds provided through IDEA, Medicaid and private insurance can also help cover the costs of interventions, such as speech therapy and hearing services. Finding a provider that is familiar with Early Intervention funding will know best how to help families cover the costs of these services. Although early intervention is mandated by IDEA and designed to meet the needs of children, it often requires a combination of resources to cover the costs of services. The ECTA’s website offers contact information for each state’s lead agency, who will be able to provide parents with the resources they’ll need to secure services and funding. If your child qualifies for interventional services, it will be important to become educated in what services must be provided at no cost to you through IDEA Part C.

What Happens When Services End?

Once a child is three, if they are still experiencing delays or require supports, then services will continue and transition into special education services. These are often provided through a child’s school at no additional cost to you. The age at which a child begins schooling also varies state-by-state, which is why it’s important for families to work with their initial early intervention team in order to ensure children continue receiving the supports they need. When an IFSP is developed, it should include any support for the transition to preschool when a child turns three. Plans should be reviewed every six months, as children change quickly from birth to age three.

Insureyouknow.org

Early intervention services can have an enormous impact on a child’s ability to meet developmental milestones. These services are provided not only for a child, but also so that their caregivers have the tools they need to create a healthy environment for their entire family. Insureyouknow.org can help you keep track of medical records, interventional resources, and your child’s IFSP, as well as their progress. When it comes time for your child to start school, having this paperwork organized in one place will help you provide their school with everything they require in order to ensure the necessary continued supports.

The Long and Short of Disability Insurance

March 1, 2021

You may have never felt you needed to consider a disability insurance policy because you are young(ish), healthy, and don’t work in a business that exposes you to risky situations. Disability insurance is designed to cover a portion of your income if something happens to you like an injury or illness and you can’t work. Beginning in 2020, adverse effects of COVID-19 have been added to physical injuries, heart attacks, and cancer as major reasons to file claims for disability insurance.

COVID-19 symptoms can linger for months while the virus damages the lungs, heart, and brain, which increases the risk of long-term health problems. People who continue to experience symptoms after their initial recovery are described as “long haulers” and the condition has been called “post-COVID-19 syndrome” or “long COVID-19.”

Older people and people with many serious medical conditions are the most likely to experience lingering COVID-19 symptoms, but even young, otherwise healthy people can feel unwell for weeks to months after infection.

COVID-19 can make blood cells more likely to clump and form clots. Large clots can cause heart attacks and strokes, much of the heart damage caused by COVID-19 is believed to stem from very small clots that block tiny blood vessels in the heart muscle. Other parts of the body affected by blood clots include the lungs, legs, liver, and kidneys. COVID-19 also can weaken blood vessels and cause them to leak, which contributes to potentially long-lasting problems with the liver and kidneys.

People who have severe symptoms of COVID-19 often have to be treated in a hospital’s intensive care unit, with mechanical assistance such as ventilators to breathe. Simply surviving this experience can make a person more likely to later develop post-traumatic stress syndrome, depression, and anxiety.

Much is still unknown about how COVID-19 will affect people over time. Researchers recommend that doctors closely monitor people who have had COVID-19 to see how their organs are functioning after initial recovery.

Many large medical centers are opening specialized clinics to provide care for people who have persistent symptoms or related illnesses after they recover from COVID-19. Most people who have COVID-19 recover quickly. But the potentially long-lasting problems from COVID-19 make it even more important to reduce the spread of the disease by getting vaccinated, wearing masks, avoiding crowds, and frequently washing your hands.

Types of Disability Insurance

If you anticipate a need for disability insurance coverage or want to provide protection just in case an unforeseen injury or illness occurs, consider the two types of disability insurance: short term and long term. Both of them are designed to replace part of your regular income if you are unable to work. Even though they basically provide the same benefits, the following are differences and similarities for you to review.

Short-Term Disability Insurance (STDI)

• How much does it cover? About 60 to 70 percent of your salary.
• How long does it last? Usually 3 to 6 months, depending on the policy’s fine print.
• How much does it cost? About 1 to 3 percent of your annual income.
• How soon until you would receive your first payout? Around two weeks after your healthcare provider confirms your disability.
• Why would you get it? If your employer offers it at no cost to you.

Long-Term Disability Insurance (LTDI)

• How much does it cover? About 40 to 70 percent of your salary.
• How long does it last? Five years or longer if your disability continues.
• How much does it cost? About 1 to 3 percent of your annual income.
• How soon until you would receive your first payout? Usually around 3 to 6 months after your healthcare provider confirms your disability.
• Why would you get it? If you and dependents rely on your income and you don’t have sufficient savings to replace your regular salary long term.

You may be fortunate to have an employer who offers disability income protection insurance. If not, you can elect it during open enrollment or you may want to choose additional disability insurance to supplement what your employer provides. Ideally, you would have a three-month cash reserve to cover you before your payments go into effect. If not, the short-term disability protection, which typically starts after 14 days, would pay until the long-term disability is in place. It is important to understand how your policy defines disability which may not match your definition or need. Usually, workplace policies have a narrower definition of disability than private policies do. Depending upon your occupation, through a private policy you may be able to elect more favorable terms. Your financial advisor or life insurance agent can help you to find a policy that’s right for you.

In the United States, individuals can obtain disability insurance from the government through the Social Security Administration (SSA). To qualify for government-sponsored disability insurance, an applicant must prove that his disability is so severe that it prevents him from engaging in any type of meaningful work at all. SSA also requires applicants to demonstrate that their disability is expected to last for at least 12 months, or that it is expected to result in death.

You may find it helpful to consult an attorney when applying for a claim, regardless of your diagnosis. Qualifying for Social Security disability benefits is determined by your medical eligibility and how severely your condition affects your ability to work—an attorney can help explain the process and represent you if your case goes to court.

By contrast, some private plans only require the applicant to demonstrate that he can no longer continue in the same line of work in which he was previously engaged. If you take out your own policy, it will stay with you whenever you change jobs. But it’s cheaper if you can buy it through your employer that may offer it when you come on board, or you can talk to your HR staff about setting it up later.

STDI replaces a portion of your paycheck for a short period of time—three to six months. Most people get STDI through their employer. You can get an individual policy through some private insurers, but these plans are usually expensive. An alternative to an STDI policy is to save 3 to 6 months of expenses in an emergency fund that you can draw upon if you get sick or injured and have to take time off work for a few months.

Long-term disability insurance (LTDI) provides coverage if you’re out of work for a longer period of time—years or even decades. It, too, is sometimes offered by employers, but even if the benefit is provided, it might not be adequate. Employees often take out individual or a supplemental LTDI policy if the benefit isn’t provided by employers.

When applying for either an STDI or an LTDI policy, make sure you find out answers to the following questions from your insurer:

• What is covered under my policy?
• Does my disability qualify me for coverage?
• When and how do I make a claim?
• What do I do if a claim is denied?

Limits of Disability Insurance

Disability insurance is only designed to replace a portion of your income—it doesn’t cover extra expenses like your medical bills and long-term care costs.

According to Mason Finance, “Most disability policies come with several built-in exclusions in order to protect the insurer from claims submitted as a result of disabilities sustained from what it considers to be ‘high-risk’ activities, such as skydiving, mountain climbing, flying in experimental aircraft, or other such activities. Your insurer may also exclude any preexisting conditions that you have when you apply for coverage.”

While pregnancy isn’t usually covered by long-term policies, complications that extend beyond pregnancy, for example, if your doctor orders you to refrain from working to recuperate from a C-section, you might qualify for benefits—but only if you had a long-term policy in place before you got pregnant. 

Short-term policies do cover birth as a disability, but you might be waiting a long six-to-eight weeks for your first payout. 

InsureYouKnow.org

If you decide to apply for disability insurance, you can track your policy, payments, and any claims you submit at InsureYouKnow.org.