A federal court decision in Florida last week has highlighted the fact that some states are still refusing to provide diapers to children covered under EPSDT.
Diapers are a medically necessary service under EPSDT. All you need is a prescription from your doctor and letter of medical necessity to present to your Medicaid provider agency. In some cases, if you already have a medical supply company you work with, you can give them the prescription and they will get the approval for you.
A study done for the March of Dimes back in September 2005 showed that diapers were a covered service under EPSDT in every state. A brochure written for parents on EPSDT by the federal DHHS states clearly diapers are covered under EPSDT.
If you are having any problems getting diapers covered for your child, please contact us and we will see what we can do to help.
PLEASE help me with this! I am in GA and my child is 8 years old. She functions on the level of a one month old baby. She is incontinent of both bowel and bladder. How can we get medicaid to cover her diapers, wipes, chux, etc??????
CDKD4454@knology.net
Who makes the decisions for your daughter’s treatments – a state employee or somebody working for a private insurance company?
Georgia has just published two bulletins on medical services for kids on Medicaid: one for parents and the other for doctors. There is no question diapers are covered.
I would recommend that you send out an email to the top authorities at Georgia Medicaid (they’re listed on the brochures) stating your daughter needs diapers immediately, she has been denied, and the brochure you’ve attached states they have to provide them for her.
At the same time, can you enlist the help of your daughter’s doctor? Give him a copy of the brochure on EPSDT for physicians that explains what he can order for her, the process, and even says requests “should not be denied.”
Let me know what other help I can give you! Feel free to email me privately if you want: summer@childrensdisabilityright.org