Early Intervention Program Letter to Parents
May 14, 2008
Insurance is a routine and required payment source for services provided under the Early Intervention Program. Private health insurance is used to help pay for early intervention services to make sure that public funds stretch as far as possible in serving children like yours who can be helped by these important services.
Under NYS Public Health Law and regulation:
- Your Early Intervention Official (EIO) must collect, and you must provide, information and documentation about your child's insurance coverage, including Medicaid and other government payers. Your service coordinator will collect this information and give it to your EIO. This information includes: the type of insurance policy or health benefits plan, the name of the insurer or plan administrator, the policy or plan identification number, the type of coverage in the policy and any other information needed to bill your insurance. Your service coordinator will explain your rights and responsibilities, and the protections that the law provides for families.
- Your EIO must collect, and you must provide, your social security number and your child's social security number.
The early intervention services your child needs will be provided at no cost to your family. You will not be asked to pay any out-of-pocket costs, such as deductibles or co-payments, for services your child and family receive in the Early Intervention Program. In addition, New York State Insurance Law prohibits insurers from charging any benefits paid for early intervention services against any maximum annual or lifetime policy limits ("caps"). This means that any payment made by your insurance company for early intervention services will not decrease your family's total insurance coverage.
If the use of private insurance would result in any cost to your family (such as if your employer is self-insured and not prohibited from applying early intervention payments against a policy cap), your insurance may not be billed without your informed consent. Incidental costs, such as the time needed to file an insurance claim or the postage needed to mail the claim, are not considered a cost to your family.
If you decline to provide your insurance information to your service coordinator, your EIO is required to notify us, unless you provide documentation from your insurer that your insurance policy is not subject to New York State Insurance Law. The EIO must certify that you have been fully informed about the protections in State law when insurance is used for early intervention services. The EIO must also inform us of the reason why you declined to provide insurance information.
The early intervention services available to your child and family will not be limited to what is covered by your insurance. Your early intervention official has to make sure that appropriate early intervention services are provided to your child, even if you have no insurance.
If you have any questions about the information in this letter, please ask your service coordinator or call the New York State Department of Health, Early Intervention Program at 518-473-7016.
Bradley Hutton, M.P.H.
Bureau of Early Intervention