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Children’s Specialized Hospital has created a website to help parents of children with special needs find the best health insurance plan to meet the complex medical circumstances of their children.The new website is www.childrens-specialized.org/insurance-education.

Amy B. Mansue, chief executive of Children’s Specialized Hospital, pointed out that employers increasingly are asking their workers to select their own health plans from a menu of choices on the employer’s “private exchange.” And under the Affordable Care Act, individuals are purchasing their own health plans on the public health insurance exchange, HealthCare.gov, which offers dozens of different health plan options.

“We recognize this is likely a nerve-wracking and complex process for parents — especially parents of children with special health care needs, ” Mansue said “When parents know what to look for, they can select an insurance plan that will help them maximize their child’s access to care so he or she can reach their fullest potential.”

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Children’s Specialized, an affiliate of the Robert Wood Johnson Health System, treats children affected by brain injury, spinal cord injury, premature birth, autism, developmental delays and other illnesses at 12 sites throughout New Jersey.

The website guides families through the information they need to assemble — and the questions they need to ask — before choosing a health plan. The website includes personal stories from families who have navigated issues like finding the right prescription drug coverage.

Mansue said the website was inspired by the trend of putting more health plan choices into the hands of the consumer.

“Families are not going to know how to pick (a plan) or even what questions to ask,” Mansue said. “So we decided to tackle this really complicated subject. We wanted somewhere for a family to go to sort through this, up front, and to have a tool to use.”

Mansue said the hospital worked on the website’s design with families, who wanted something user-friendly.

 “They told us, ‘Look, we’re so overwhelmed already, we are taking care of kids with disabilities, so don’t make this complicated.’ ” The website has a concise tutorial on how to approach choosing a health plan, with additional resources “for those who want a deeper drive” into the complexities of health coverage, Mansue said.

“This is about helping families navigate what can be a really complicated insurance world.”

For example, a child who suffers a traumatic brain injury will generally have access to all necessary inpatient care during the initial acute phase of the injury. But Mansue said that, once the child is discharged from the hospital and becomes an outpatient, the amount of therapy he or she receives can vary from one insurance plan to another.

“It is important for families to know that up front” before they choose a health plan, she said. “Parents need to understand what is covered and what isn’t.”

State Sen. Joseph Vitale (D-Woodbridge), chairman of the Senate Health Committee, commended Children’s Specialized Hospital for taking on this project.

“Everyone needs to understand what is and isn’t covered by their health insurance,” Vitale said. “Parents, particularly parents of children with long-term health needs, need to make sure they’re asking the right questions about a health plan’s coverage. This resource provides parents with the right questions to ask.”

The website “is an invaluable, one-of-a-kind resource for families of children with special needs and the advocates who serve them,” said Diana Autin, executive co-director for health and family support, Statewide Parent Advocacy Network, or SPAN. She said her staff will use the website to “help families navigate the complicated and confusing maze of health coverage in New Jersey.” 

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