Aging Out of EPSDT – Part IX: More Strategies


In the last post, we talked about how families with disabled children aging out of the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program in a non-Medicare-expanded state might deal with the likely failure of the system to provide for their loved one’s health care. We’re doing the same thing here, but looking at a handful of smaller programs.

Military Benefits

If you are a veteran and the parent of a disabled adult child, you can ask the military to designate your child an Incapacitated Dependent, which will qualify them for limited TRICARE benefits. Like most such benefits, those offered by SSI and Medicare are more comprehensive, but should they not qualify, TRICARE can at least contribute something.

Start a Charity

There are a startling number of ways to ask for charitable donations in today’s connected world, from old-school options like putting coin banks on the counters of local stores to social-media-friendly options like GoFundMe. These can be highly successful short-term options, but they tend to not last over an extended period of time. Also, in most states, the only wise way to deal with the proceeds of such a charity is by setting up a Special Needs Trust — any other disbursement might end up counting as income for the person with special needs, and thus quite accidentally get them kicked off of Medicaid or SSI. Ask a lawyer before you go this route.

Apply for a Grant

Not that many grants exist in the United States for families — most of them are by organizations, for organizations — but a few do. The list available at is a good place to start for nationwide resources; for more local opportunities, inquire at your Area Agency on Aging. Finally, consider looking up resources specific to your loved one’s disability, such as this list for people on the autism spectrum.

Seek a Tax Break

For certain extremely poor families who spend an extraordinary amount taking care of a disabled loved one, the tax break for medical expenses might be worth their while. Essentially, everything you pay for your family’s medical expenses over 10% of your adjusted gross income is deducted from that taxable income. It’s really not much, but for families in such desperate straits that 11% or more of their gross income is going to medical bills, it could literally be a lifesaver.

Leveraging Existing Resources

Many families, while poor in income due to economic circumstances and burdened by staggering amounts of debt, nevertheless have some surprising resources at their disposal. If you know for certain that your disabled loved one is going to be able to get coverage by a certain time, you could consider getting a reverse mortgage and pulling some money out of your home’s equity to help you make it that far.

Bridge Loans

Similarly, several lending institutions (particularly credit unions and other local banks) offer ‘bridge loans’ to families who can show that they have a defined waiting period they need to cover in order to ‘bridge’ successfully onto Medicaid or a similar comprehensive program. These loans will need to be paid back, but they are a tool that shouldn’t be discarded out of hand.

Peter Mangiola, RN MSN has been in the health and wellness industry for over three decades. He has served in Emergency, Recovery, Cardiac Care, and Electrophysiology departments, as well as three years as an Oncology Director, three years as director of an adult cystic fibrosis program, eight years as Charge Nurse for a cardiovascular nursing unit, and several years as owner/operator of two well known New Jersey Senior Care agencies. Peter has been a regular speaker for many groups and organizations over the years covering a wide range of topics. He has also been a consultant, speaker, and educator in areas such as Dementia, Alzheimer’s, cognitive/behavioral issues, disabled children & adults, and obesity counseling. Learn more at

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