Medicaid & Private Insurance | For Neurodivergent Children (Birth–18)
As a pediatric nurse and special needs mom, I strongly believe that knowing what to ask for makes a huge difference.
Many families miss out on options simply because they were never told those options existed. This guide is meant to help you understand what may be available, what language to use, and how to navigate the process — especially if you’ve already purchased equipment and are exploring reimbursement.
This information is educational. Coverage varies by state and insurance plan, and not all families will qualify.
Depending on medical necessity and documentation, some families have been able to obtain or be reimbursed for:
• Spinning or vestibular chairs
• Crash pads
• Adaptive or posture-support seating
• Weighted blankets
• Other equipment supporting regulation, safety, or daily functioning
These items are often reviewed under Durable Medical Equipment (DME) or therapy-related benefits.
It can be especially helpful if your child is already receiving occupational therapy, whether through school-based OT or an outpatient therapy provider. Insurance companies often look at whether OT is part of your child’s care plan and how equipment supports progress, regulation, safety, or functional participation.
When discussing equipment with providers or insurance, wording matters. Helpful language may include:
• Regulation
• Safety concerns
• Postural support
• Sensory processing needs
• Daily functioning and participation
Medical necessity should clearly connect the equipment to your child’s functional needs.
Some insurance plans require a Letter of Medical Necessity and/or a prescription. This documentation may be written by a pediatrician, specialist, or therapist and should include:
• Your child’s diagnosis
• Functional challenges being addressed
• How the equipment supports daily life
• Why the equipment is medically necessary
If you purchased equipment out of pocket (for example, online or through a retailer), you may still be able to seek reimbursement.
In some cases, you can ask your pediatrician or therapy provider to help create documentation to support reimbursement. This may include:
• A diagnosis code (such as autism or another qualifying diagnosis)
• A brief medical necessity statement
• The amount paid for the equipment
Even if you did not receive a traditional superbill from the seller, your provider may be able to document the purchase so you can submit it to insurance.
Each insurance plan has its own process. Typically, reimbursement requests include:
• Proof of payment or receipt
• Medical documentation or diagnosis codes
• Any required insurance claim forms
If needed, there are tutorials available that walk through how to submit superbills and reimbursement claims step by step.
If you need additional help, you can use the contact form on the Itsy Bitsy Toddler & Co. website (itsybitsytoddlerco.com) to reach out. Messages submitted through the contact form go directly to the team, including resource coordinators who may be able to assist.
Please note: responses may take a little longer during recovery periods or holiday breaks, but all messages are received and reviewed.
Not every request will be approved, and coverage varies widely. However, understanding the process, knowing what to ask for, and using the right language gives families the best opportunity to explore available options.