How I Got Medicaid to Pay for Disposable Diapers

By Xiomara Montes

My daughter, Xaymara, is four years old. She has spastic quadriplegic cerebral palsy, as well as  epilepsy, seizure disorder and cortical blindness. We are a military family. When Xaymara was born premature at 29 weeks and we could see her development delays, we decided to move from Puerto Rico to the United States to provide her a better quality of life. We gave up everything we had in Puerto Rico to make the move, but her health and medical care were the most important things to us.

Xaymara receives Supplemental Security Income (SSI) and is also covered by Medicaid. As a military family, we also have military insurance. This insurance has paid for all the doctors, specialists and medical equipment that my daughter has needed. The one item we had trouble getting our military insurance to cover was disposable diapers. Here’s how we solved that problem:

First, we submitted the expense to the insurance company and received a denial. Then we called the company that supplies the diapers and told them we had been denied, but that we were covered by Medicaid. The company asked us to send them a “letter of necessity” from our doctor. We called the doctor and asked him to fax the information to the company. We also sent the company our Medicaid information. When the company received approval from Medicaid, they began sending us a monthly supply of diapers.

The lesson from this story is that even if you are denied by one agency, keep trying. Also, enlist the help of the company that sells the product or service you need.

Letters of necessity are super important when trying to get payment for equipment or supplies. For more information read Tips for Writing Letters of Medical Necessity.

CP Family Network offers more information on Medicaid and other government funding programs for children with cerebral palsy. Other helpful websites include:

http://www.medicaid.gov