Healthcare Delivery System Bhs 450 Module 4 Slp

3 March 2017

BHS450 Module 4 SLP The children’s healthcare program in Maryland is called the Children’s Medical Services Program (CMS). The requirements for eligibility are pretty cut and dry. You must be between the ages of 0-21 years of age with a disability or chronic illness that needs medical evaluation and/or monitoring. The child must be a Maryland resident, and the parent’s must meet the CMS Program’s income requirements.

The income eligibility scale provides several examples to assist future beneficiaries in seeing if they qualify for CMS for their child. They provide the following: •“If a family of three has an annual income of $35,000, the family’s annual income would qualify the child for the CMS Program.

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•If a family of three has an annual income before medical expenses of $38,000 and has made annual payments for eligible medical expenses of $2,000, the family’s annual adjusted income of $36,000 would qualify the child for the CMS Program. If a family of three has an annual income before medical expenses of $38,000 and has made annual payments for eligible medical expenses of $600, the family’s annual adjusted income of $37,400 would not qualify the child for the CMS Program. •If a family of three has an annual income before medical expenses of $47,000, the child would not qualify for the CMS Program regardless of the amount of annual payments for eligible medical expenses. (Maryland State Health Department) They must not qualify for any other source of health insurance, or must have health insurance that does not meet all of the child’s special medical needs. CMS covers a broad array of medical services to include Laboratory Services, Radiology, Allergy/ Immunology, Cardiology, and Oncology. Other services require special conditions. For example, Dental Services are only provided if the child has a specific condition related to dental care. Also, Neurobehavioral treatment is limited on to the medical diagnosing of a disorder.

A plus that is also included is Plastic Surgery for children who suffer from a cleft lip or palate. Besides the few medical services that are limited, CMS provides routine healthcare to those children whose families need the assistance. Based on residency, age and financial situation, CMS accepts many children under its wing. References: TRICARE Prime. Retrieved on July 18, 2010 at http://www. tricare. mil/mybenefit/home/Medical/Costs? plan http://www. tricare. mil/mybenefit/Download/Forms/Prime_HB_09_L. pdf

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