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The use of Insurance for Special Education

A common question that will be asked of you as your child is enrolled in each state sponsored special education program is: "Do you mind if we bill your insurance?"

The question can be restated as "Do parents of children with disabilities have to allow school districts to use their medical insurance benefits to provide appropriate services to their children?" The answer is found in public law 94-142 the Education for All Handicapped Children Act (EHA). This law states that States receiving federal funding under this act must provide this service as no cost to the parents, and this includes transportation. Therefore, according to the law, you do not have to allow your insurance to be billed for any services that are provided to your child by an agency receiving federal funds.

Why do parents allow their insurance to be billed? It may be out of ignorance of the laws, a desire to help the school system, or possibly out of fear that their child will not receive the best of care. Parents sometimes choose to deny the use of their medical insurance in order to protect the child's coverage, to protect their child from a diagnostic label that may be required by the insurance company, or to protect their ability to obtain future medical insurance if their life or employment situation changes.

Remember, the use of your medical insurance to cover special education needs is purely voluntary. If you have doubts, check with your insurance agent or your companies insurance plan administrator for advice before you agree to the use of your benefits. If you fear that your child will receive "less adequate" services without your consent to insurance, you might want to contact your Regional Office of Civil Rights or a local chapter of a support group such as Learning Disabilities Association of America for assistance.

Two interesting court cases have granted an adult with mental retardation the right to sue the school district that had spent $64,000 of a lifetime medical benefit of $100,000, and a ruling that an insurance company is not required to reimburse a school district for services.


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