first timer
New member
Has anyone else in a 50/50 access arrangement had to figure out how to allocate a government grant between 2 households?
Assistive Devices Program
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first timer
New member
Splitting the grant 50/50 was the intent initially but I am being told that it may not be doable because our health insurance providers will take the amount of the grant off the top of the costs of supplies before reimbursing any costs over the amount of the grant. Hoping other ppl may have dealt with a similar situation and can offer some guidance.
Hopefully.
I do not understand fully, what is being asked for here. It would make sense to me, that the insurance company probably has a policy that government grant is applied towards costs first, and then insurance pays out the lesser amount.
Why does it have to be split between households? Is there more than one person requiring this "grant". I would think the grant would follow each person, to their new households. Or is this for a child, that goes between each home?
OhMy
New member
The grant would be named in the childs name vs the parents.
You can do a few things to try to obtain this information as it really is dependent on whether the ADP funding is for supplies or equipment.
-First you may wish to contact the vendor of such supplies or equipment to see how they do this with ADP, ie what they do when ADP and private insurance is involved and how it is billed etc.
It may be that they bill insurance and ADP directly (depends on what the item is), or you or the other parent get billed directly and then you submit the claim and get reimbursed. In the latter case it would make sense as normally the insurance will only reimburse the parent who has the plan,for that parent to order and pay initially for said items and ensure there is enough of said items to go to the other parents household, then the remaining portion (not covered portion of cost of said items) would be considered a section 7.
-Second - try phoning ADP and ask them.
Tel: Toronto 416-327-8804
Toll-free 1-800-268-6021
TDD/TTY 416-327-4282
TDD/TTY 1-800-387-5559
Fax 416-327-8192
e-mail: adp@ontario.ca
this may be simplistic - but it is how multiple insurers operate - which they would take into account any other forms of reimbursement or grant if paid in advance......
In my case, mom's insurance paid out the max to the plan AFTER any deductibles. dad's would come in and following the deductible if any it would then pay out to the max.
the grants to an insurer would be the equiv. to paying the deductible portion and what was left over would then cover the insurer cost to the amount of the grant to cover its expense to covering the cost of the service - anything not covered by the grant would then be jusy a regular expense cost to the insurer as if there was no grant in the first place. As you are aware, the insurers will only cover up to the max allowed by your particular plan.
if the above made sense, in our past we had a child who required surgery, then ortho type bracing to allow the child's legs to heal and grow even, straight and strong. What we did to ease our confusion was to identify both insurers of each other's existing plan and coverages by sending the written plan parameters to both insurers so they knew up front what the scoop was -- then we all got together so everyone was "on the same page". So in the end the second insurer allowed us the credit for any deductible we covered on the first plan and the second plan took over and covered the rest of each month's billing (we went on a monthly payment plan for two years to cover the expenses as the treatment progressed as it allowed us the best tax credit consideration for our yearly employment taxes - it would have been advantageous to get it all paid in one year to max that credit but we just couldn't afford it all in one year.
If I got this right as far as your particular circumstance (you did lack detail) then the most important step is to get all the parties the full plan details and the insurers who handle these type of two, three or more participating parties to cover these big expenses (who is the first to pay, second, third etc.)...... now that I think of it, we were lucky in that the two insurers ended up assuming 100% of the expense and we paid NIL as far as our deductible...
hope that helped!!
In my case, mom's insurance paid out the max to the plan AFTER any deductibles. dad's would come in and following the deductible if any it would then pay out to the max.
the grants to an insurer would be the equiv. to paying the deductible portion and what was left over would then cover the insurer cost to the amount of the grant to cover its expense to covering the cost of the service - anything not covered by the grant would then be jusy a regular expense cost to the insurer as if there was no grant in the first place. As you are aware, the insurers will only cover up to the max allowed by your particular plan.
if the above made sense, in our past we had a child who required surgery, then ortho type bracing to allow the child's legs to heal and grow even, straight and strong. What we did to ease our confusion was to identify both insurers of each other's existing plan and coverages by sending the written plan parameters to both insurers so they knew up front what the scoop was -- then we all got together so everyone was "on the same page". So in the end the second insurer allowed us the credit for any deductible we covered on the first plan and the second plan took over and covered the rest of each month's billing (we went on a monthly payment plan for two years to cover the expenses as the treatment progressed as it allowed us the best tax credit consideration for our yearly employment taxes - it would have been advantageous to get it all paid in one year to max that credit but we just couldn't afford it all in one year.
If I got this right as far as your particular circumstance (you did lack detail) then the most important step is to get all the parties the full plan details and the insurers who handle these type of two, three or more participating parties to cover these big expenses (who is the first to pay, second, third etc.)...... now that I think of it, we were lucky in that the two insurers ended up assuming 100% of the expense and we paid NIL as far as our deductible...
hope that helped!!
smileandwalkaway
New member
Not exactly sure what you are asking but I can say that in my experiences that any subsidies, financial aid, specialized benefits, programs, etc. that my special needs child has received, each had their own guidelines which dictate the order it is applied towards the expense. Sometimes it is applied before benefits hru employment from myself and my ex, sometimes it comes after.
I suggest you contact the source of this grant to see what their individual process is.
I suggest you contact the source of this grant to see what their individual process is.