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Supporting parents of children with mental health challenges to be their child's best advocate
"Why doesn't insurance cover my child's needs?"
PH95 could be the solution.
*You may have previously heard of PH95 referred to as "the Loophole"
What is PH95*?
If your child has significant mental health, behavioral health, developmental, or disability-related needs, they may qualify for additional coverage through Pennsylvania Medical Assistance under PH95.
PH95 is a Pennsylvania Medical Assistance category that may help children access services that private insurance does not fully cover.
Some families hear about PH95 from another parent, therapist, school advocate, or provider after struggling to get services approved through insurance.
PH95 may help cover services related to:
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mental health treatment
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behavioral health supports
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autism services
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therapy
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wraparound services
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additional Medicaid-covered care
Eligibility is based on your child’s needs and circumstances.
For more information check out this helpful guide from the Pennsylvania Health Law Project.
Will my child qualify?
Your child needs to be under the age of 18 to qualify for PH95.
They also must have a severe disability and mental health challenge that meets the Social Security childhood disability standards.
While checking out the standards is helpful - do not let it deter you from applying. Don't be discouraged from applying just because you think you child does not qualify.
Hear Parents Just Like You Discuss PH95
On our podcast This is Not What I was Expecting Christina and Melissa break down what PH95 is and how Pennsylvania families can apply!
I want to learn more before I apply...
Most services for mental health are Medicaid based, making applying to PH95 so important and effective in getting your child the treatment they need to thrive.
If you are a Pennsylvania parent who is interested in hearing more about PH95 reach out to one of our Family Support Partners (FSPs) today!
Our peer support service will pair you with your very own FSP who can help you navigate the process of getting your child covered through PH95.
Did you know that PH95 gives you access to local resources that insurance usually does not cover?
Talk to a Parent Peer Support Partner to discuss the process of applying and hear more about the resources that are in your community!
Check out these great resources on PH95!
For a clearly written, detailed guide on who is eligible and how to apply for PH95 from the PA Health Law Project click here!
Need legal help figuring out PH95? Check out the PA Health Law Project's website here!
Check out this resource for a child who has Medicaid