New Port Richie, Florida
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Sarah Borscha, age 6, was born with Apert’s syndrome, a rare genetic disorder that disrupts normal bone growth and causes malformations of the skull, face, hands and feet. The medical costs associated with Sarah’s care are enormous. She has already required numerous surgeries, and her needs for special shoes and foot braces, prescription medications, and speech and physical therapy, are ongoing. As she grows, she is likely to need additional operations on her face, mouth and jaw. Medicaid has covered Sarah’s care since birth, ensuring that she has access to the extensive care she needs, despite her family’s very modest income.
Because of Sarah’s genetic condition, she has needed extensive health care services since she was born. She received Medicaid immediately, and she continues to get comprehensive coverage through Medicaid’s Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit. EPSDT, the Medicaid benefit package for children up to age 21, covers many services and treatments not typically covered by private insurance. Under EPSDT requirements, states must provide children with all medically necessary services allowed under Medicaid law, even if the state does not cover some of these services for adults in Medicaid. One in seven children has special health needs that may require more intensive use of acute care services, as well as services such as physical, occupational, and speech therapy, and durable medical equipment. In addition to these services and supports, Medicaid covers non-emergency transportation, interpretation services, case management, and other assistance that helps low-income children secure access to needed care.
"We would've been buried in medical bills if it wasn't for Medicaid. Medicaid is pretty much a daily part of our lives." – Sarah's father, Robert