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Advice For Families Regarding Transition Plans From Regional Centers To Medical Insurance Providers.

Remember that as a result of SB 946, individuals with Pervasive Developmental Disorders or Autism are entitled to use their medical insurance to obtain services. Specifically, as of July 1, 2012 and until July 1, 2014 individuals in the state of California can now use their medical insurance to obtain services. Also remember that it appears that SB 946 does not apply to a medical insurance plan that does not provide behavioral health or mental health services, a health care service plan in the Medi-Cal program, a health care service plan in the Healthy Families Program, or health care benefit plan or contract entered into with the Board of Administration of the Public Employees’ Retirement System.

Given this situation, California’s regional centers have begun informing families and service providers that services will be transitioning over to medical insurance providers. Depending on what regional center you receive services from, the speed with which families will need to transition will vary. We have seen that range between thirty to ninety days. Additionally, the situation for co-pays and deductibles will vary depending on your regional center. Some regional centers are taking the position that they will not pay for co-pays or deductibles while others are willing to do so.

We urge families to get in contact with their service coordinators to get copies of the proposed regional center plans (developed by each regional center) so that families know what they are facing. That is, how soon will you have to have your services transitioned over to your insurance plan and what will you expect with respect to co-pay charges and deductibles that consumers of medical services are typically expected to pay. It is anticipated that families will run into barriers and confusion with their respective medical insurance companies. These issues may result in delays in transition and hopefully won’t further result into interruptions of services.

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“If this was what it was going to take to get him to walk out of the house and be able to go to the supermarket again, then I was all for it.”

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