Health Insurance Support
Understanding health coverage options families often overlook
Health insurance systems can be confusing—especially for families raising children with disabilities or complex medical needs. Many supports exist within public and private insurance systems, but they are often poorly explained, inconsistently shared, or misunderstood.
This page provides clear, family-friendly explanations of health and insurance-related supports that families are frequently not told about. The goal is not to determine eligibility or replace professional advice, but to help families understand what types of options exist so they can ask informed questions and plan more confidently.
This page is informational. ​Some families also benefit from one-to-one navigation support, which is listed later on this page. Eligibility, coverage, and availability vary by state, insurer, and individual circumstances.
Why health and insurance supports are often misunderstood
Families often miss available insurance supports because:
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Rules differ by state and program
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Children with disabilities may qualify under different criteria than adults
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Income is not always evaluated the way families expect
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Some programs are optional or must be requested
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Information is often shared only after a denial or crisis
As a result, families may assume they have “no options” when additional pathways exist.
Types of health & insurance supports families often overlook
Below are categories of health and insurance supports families may encounter, along with specific examples that are often not explained clearly or proactively shared. These examples include Nevada-relevant supports. This list is not exhaustive and eligibility varies by state, program, and individual circumstances.
Medicaid pathways for children with disabilities
Some Medicaid eligibility options consider a child’s medical or functional needs rather than household income. Examples include:
• Katie Beckett / TEFRA Eligibility Option (Nevada)
This Medicaid option allows children with disabilities who would otherwise need institutional care to qualify for Medicaid coverage based on the child’s situation, without counting parental income in eligibility determinations. This can make coverage possible for families who might assume they earn too much to qualify.
In many cases, families first qualify for Medicaid through an eligibility option like Katie Beckett and then apply separately for HCBS waiver services.
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Disability-based eligibility categories
Other states and Nevada may have pathways that adjust eligibility rules for children with specific medical or functional needs.
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Home and Community-Based Services (HCBS) waivers
HCBS waivers provide supports that help individuals remain at home and in the community rather than in institutional settings. These services may include personal care, respite, therapeutic supports, and caregiver assistance. Families are often not told about these options early, and they may require separate applications or placement on waiting lists.
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Health Insurance Premium Payment Programs (HIPP)
• Nevada HIPP (Health Insurance Premium Payment Program)
HIPP identifies Medicaid recipients with access to employer group health insurance and, when cost-effective, assists with paying premiums so families can keep employer-sponsored insurance and supplement it with Medicaid.
This program can help reduce out-of-pocket costs and broaden provider networks, but families are often unaware it exists.
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Children’s Health Coverage Programs
• Medicaid Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)
Under federal law, children enrolled in Medicaid are entitled to EPSDT benefits, which include a wide array of preventive and treatment services. Families may not realize that Medicaid covers services such as dental, therapy, eyeglasses, and medical equipment when medically necessary.
• Nevada Check Up (CHIP)
Nevada’s Children’s Health Insurance Program (CHIP) provides low-cost comprehensive coverage for uninsured children who do not qualify for Medicaid and helps promote continuity of care. Premiums may be charged quarterly, but services are often much more affordable than private plans.
Premium assistance & coordination programs
Some programs help families coordinate private and public coverage or assist with premiums, copays, and deductibles. These supports may:
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Reduce financial strain
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Allow families to use private insurance as primary coverage
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Enable Medicaid or CHIP as secondary coverage
Because these programs are less commonly advertised, families may not realize they exist until a specific conversation or referral occurs.
Questions families may want to ask
When exploring health and insurance supports, families may find these questions helpful:
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Are there Medicaid eligibility options in my state that focus on children’s medical or functional needs rather than parent income?
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Does my state offer a premium assistance or HIPP program that can help with employer insurance costs?
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Can Medicaid or CHIP be used alongside my private insurance to cover additional services?
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Are there HCBS waivers or separate applications that could support care at home or in the community?
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What preventive, diagnostic, and treatment services does EPSDT cover for children under Medicaid?
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If I was denied in the past, should I ask again or appeal based on a different eligibility pathway?
These questions do not guarantee eligibility but can help families ask targeted questions and understand potential options.
Nevada health and insurance resources
The resources below are provided for educational reference. Program rules and availability can change and may vary based on individual circumstances:
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Nevada Medicaid – State Medicaid coverage and eligibility.
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Nevada Check Up – Low–cost health coverage for children.
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Nevada Division of Welfare and Supportive Services – State agency administering Medicaid and CHIP eligibility in Nevada.
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Nevada Health Insurance Premium Payment Program (HIPP) – Information about HIPP and premium assistance.
These links are for educational purposes only.
AJ Family Support Foundation does not administer these programs and cannot determine eligibility.
Home and Community-Based Services (HCBS) waivers
HCBS waivers allow eligible individuals to receive services in their homes and communities rather than institutional settings.
These services may support:
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Personal care or respite
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Behavioral or therapeutic supports
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Community participation
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Caregiver assistance
Waivers often have:
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Waiting lists
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Separate applications
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Different eligibility rules than standard Medicaid
Families are not always told about waiver options early.
Premium assistance & insurance coordination programs
Some programs help families keep employer-sponsored insurance by assisting with premium costs or coordinating coverage with public programs.
These supports may:
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Reduce out-of-pocket expenses
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Allow families to maintain provider continuity
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Supplement private insurance rather than replace it
Because these programs are less commonly advertised, families may not realize they exist.
Secondary and supplemental coverage
In some situations, a child may have:
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Private insurance as primary coverage
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Public insurance as secondary coverage
- This coordination can help cover:
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Services not included in private plans
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Co-pays or deductibles
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Extended therapies or supports
- Understanding coordination of benefits can significantly reduce financial strain.
Common misconceptions families encounter
Many families delay exploring options due to beliefs such as:
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“We make too much to qualify for anything.”
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“We already have insurance, so there’s no help.”
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“If it was available, someone would have told us.”
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“Applying will affect our immigration or employment status.”
- These assumptions are understandable—but not always accurate.
Family Navigation & One-to-One Support (Nevada)
Understanding health and insurance systems can feel overwhelming—especially when eligibility rules, applications, and program names are unfamiliar. Some families benefit from one-to-one navigation and peer support to help make sense of options and next steps.
The following Nevada-based resources provide free, family-centered support. They do not determine eligibility or enroll families in programs, but they can help families understand systems, identify options, and prepare informed questions.
Nevada Family Navigation Network (FNN) – Family-to-Family Health Information Center
FNN provides individualized support to families of children and youth with special health care needs. Staffed by parents with lived experience, FNN helps families navigate health systems, understand insurance and benefit options, and connect to community resources across Nevada.
Parent to Parent of Nevada
Parent to Parent offers one-to-one peer support by matching families with trained parent mentors who share lived experience. Support may focus on emotional encouragement, system navigation, or transitions related to diagnosis, services, or care needs.
Nevada 2-1-1
Nevada 2-1-1 connects families to a wide range of health and human services, including insurance assistance, disability resources, housing, food, and community programs. It can serve as a starting point when families are unsure where to begin.
These resources are shared for educational and referral purposes. AJ Family Support Foundation does not administer these programs and cannot determine eligibility or enrollment.
Why understanding insurance supports matters
When families understand what types of health and insurance supports exist, they are better able to:
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Ask informed questions
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Appeal or reconsider denials
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Plan for transitions and long-term needs
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Reduce unexpected medical expenses
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Advocate effectively for their child
Information does not guarantee approval—but it creates options.