Paying for a family member’s health treatment can be complicated as health care funding varies from state to state and from one insurance policy to another, constantly changing. ACPA’s newly revised factsheet, Paying for Treatment, explains who pays for cleft and craniofacial care, describes problems that may come up with paying for certain services and how to solve them, and lists service organizations and other resources that can help families pay for care.
According to Paying for Treatment, funding for cleft and craniofacial care may come from one source or from a combination of sources, such as:
- Employer-based or group-based health insurance
- Military health insurance (Tricare)
- Health coverage funded by Medicaid
- Health coverage funded by programs like CHIP and CSHCN
- Assistance programs through hospitals
- Assistance from private service organizations
Many people often ask, “Can my cleft team help with insurance questions?” The answer is yes.
The specialists on a team are experts in cleft or craniofacial care, but they also have experience with issues related to paying for treatment. If an insurance company denies a claim for a service, the team will know the best ways to show “medical necessity.” Your treatment team is a critical resource for the challenges of insurance coverage.
A list of ACPA Approved Teams is available on the ACPA Family Services website. ACPA Family Services provides educational booklets and fact sheets that can be downloaded online or purchased in bulk. Families may also email firstname.lastname@example.org or call (919) 933-9044 to have a complimentary copy of booklets mailed to them.