Health

December 2014-January 2015 2015 Graduates Aging Out of the School System: Step to Accesing Services/Supports from the Division of Developmental Disabilities (DDD) This timeline applies to students who have exhaused their educational entitlement by turning 21 years of age within the 2014/2015 school year. 2015 Graduates Aging Out of the School System: Step to Accesing Services/Supports from the Division of Developmental Disabilities (DDD).pdf

The Arc of New Jersey FACT SHEET.pdf
Persons with Intellectual and Developmental Disabilities (I/DD) Who Have Medicaid and Private Health Insurance

Can a person with a disability have both private health insurance and Medicaid?
Yes, a person with a disability can have both private health insurance and Medicaid. Individuals with I/DD who are age 18 and older frequently have both Medicaid and private health insurance through their parent’s group health insurance coverage.

Why is it important for a person with I/DD who already has private health insurance, to have Medicaid also?
In order to access NJ Division of Developmental Disabilities (DDD) services at age 21, individuals with I/DD are required to have Medicaid.1 The best way for a person with I/DD to receive Medicaid is by applying for Supplemental Security Income (SSI). When the individual is determined to be eligible for SSI, he/she will automatically receive Medicaid also. (See also the Fact Sheet on SSI.)

Is there any negative impact on a person’s private health insurance if he/she has Medicaid also?
There is no negative impact on the person’s private health insurance by having Medicaid also. The private health insurance is the “first payer”, and Medicaid is the “payer of last resort.”

If individuals have both private health insurance and Medicaid, will they lose access to the doctors they have seen through the parent’s private insurance coverage?
When individuals with disabilities receive Medicaid in addition to their private health insurance, they will not lose access to any of the doctors they have seen through their private health insurance coverage.

In the future, DDD services will change to a Medicaid fee-for-service system. Will this change have any impact on individuals with I/DD who have their parent’s private health insurance and also have Medicaid?
DDD’s new fee-for-service system will not have any impact on a consumer’s access to the parent’s private health insurance coverage.

When a person has both private health insurance and Medicaid, will he/she have any additional benefits through the Medicaid coverage?
When medically necessary, Medicaid covers some health services that are usually not covered by private health insurance, e.g., incontinence supplies and personal care assistance services for people with significant disabilities who need help with the activities of daily living (ADLs), such as bathing, dressing, feeding, etc.

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Occasionally, the parent of an individual with I/DD has retired, become disabled, or died before the son/daughter’s 18th birthday. In these situations, it is likely that the son/daughter with I/DD has been receiving a substantial Social Security Disability (SSD) benefit on the parent’s work history before they could have applied for SSI. DDD recognizes that individuals in this situation are probably not able to obtain SSI or Medicaid. There is a process to document this type of situation. Please contact info@arcnj.org for further information.

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