Hi, do any of you know if the EI program through the state is free? I had my son evaluated and the evalulation is free. However, the fee for the PT and OT that he needs will be based on family size and income. I have had several friends tell me that his OT and PT should be free since it is all provided through the state. Does anyone know for sure?
Thanks, everyone, for your responses. Everything that you have told me about the fee and the program is exactly what I had been told by the service coordinator. I do not have any issues with paying the fees as I know to get them privately would be much more costly and I want my son to get the help he needs. I was just confused when people starting telling me that it should all be free. You have all clarified things for me and I want to thank you all so much for your input and your well wishes for my son. Thank you!
you will have a monthly fee based on family size and income. This will be for all services through EI.
You pay the state a monthly "Family Fee," based upon the number of people in your family and your family's Annual Gross income. You must provide a copy of the 2 most recent paystubs, or a copy of the most recent year's Federal Tax Return.
It doesn't matter if you get one therapy session with the PT and OT once every other week, or if you get them each to come twice a week -- you still pay the same monthly fee. Keep this in mind when you have your IFSP meeting.
Please keep in mind: these therapists generally charge $150 per 45-minute session. If you were paying an OT and PT that much out of pocket on a weekly basis, your costs would be $1,200 per month. So the fee you pay the state is significantly less.
The evaluation is free.
The OT/PT will be based on family size and income. Your friends might or might not be giving you correct information. It all depends on how many members are in your family and how much income you and if, married/partnered, make.
Yes, the OT/PT is provided "through the state". The providers (therapists) receive payment through the state. You do not pay them directly. Depending on what fee you will be assessed, you will pay the state of Illinois monthly. Each month you will receive a statement that outlines the charges that the therapists bill the state. You pay your portion, the state picks up the rest.
It's a HECK of a lot less expensive than going privately through a provider of your choosing. Fortunately, our experience with an EI speech therapist was outstanding, so don't think that just because it is 'the state' providing the services that they will be second-rate; that simply is not the case.
Hi C.!
So far the info from previous posters is right on. EI used to be free, back when it started in the mid-90's, then the program neared collapse due to lack of funding.
Yes, families are now generally assessed a family fee based on size/income and this does not change in relation to the number and quantity of services provided- which frustrates some families for good reason! So, if you just receive 45 minutes of PT per week and another family receives twice weekly OT, PT, Speech, Vision, Nursing care, transportation and an aquatic therapy session- you all pay the same family fee based on your individual case. Does that make sense? So, if you pay $100 a month, it is the same whether your child is seen 4 times in a month, or 20 times!
One thing that has not been mentioned: insurance! If you have insurance, the State will bill your insurance first before they will pay out. If you have insurance, you are required to provide that information. Families used to be able to "opt out" of using their insurance and most did; however, now it is much harder to get an insurance exemption, although the State may still provide one in special cases. The good news is, the State will cover your deductible if they are billing insurance; you just pay the family fee. For some families, it makes more sense financially to just use their own insurance and skip the EI involvement. And some families prefer to go to a clinic of their choice and skip having therapists in their home and just use their insurance.
Your EI therapists bill the State for each session, then they receive payment from the State. All therapists must be receive a special credential to provide care through the State and many therapists have lots of experience in pediatrics- but some do not. So, just know that you can always request a new therapist if the one the State initially assigns is not a good match for you and your child.
If you have any other questions, feel free to email me. Also, call your service coordinator- they can be a great resource!
Good luck and best wishes to your son!!
You have gotten some very good responses. Early Intervention is free for those families with Medicaid/KidCare. All other families pay based on income. You can also apply for a fee waiver if you are experiencing financial difficulties due to medical bills, job loss, etc. Call your service coordinator and she can give you the application for the fee waiver.
Hi-
We just finished EI not too long ago. Everyone is right. There is a sliding monthly fee for therapists or even further evaluations (Our downtown eval and developmental psych eval was covered under this monthly fee as well.) We did provide the state with information from both of our insurances (we were double-covered) and the state billed them. We still paid our monthly fee, and at the end of the year, we were sent a statement with how much we had paid the state, and how much they had paid out for services for my son. After a short period of time (6 months, I think) we were able to request that the balance of our payments for that particular year be refunded to us, which it was. I just wanted to clarify that if you pay your monthly fee and give them insurance information, you could end up getting some or most of your monthly fee returned to you.
Hope this helps! By the way, you will wish you still had EI if your child goes into the school district system at age 3; Services are often NOT provided 1:1, and only given in 15 minute increments as per the school district's recommendation and only per issues that affect the child's education; PT is often very hard to get at all. Good luck!
