What is excluded
The Self-Direction Guidance excludes medical visit co-pays, and hospitalisation and nursing-home costs, from OTPS. Treatments that are experimental are excluded as well.
The question is usually who owes it
Medical costs generally sit with Medicaid State Plan, private insurance, or another legally responsible payer before OPWDD is the right door. Kit treats that as a routing question and tries to answer it early, because sending a family down the wrong route costs weeks.
A denial from the responsible payer is often the document that matters for what comes next, which is why Kit records it rather than treating it as a dead end.
What Kit can do
Kit can research which route an expense belongs to, preserve the sources it relies on, and prepare a draft request for your review. It cannot approve anything, and neither a Kit page nor a provider listing is an OPWDD or Fiscal Intermediary decision.
One useful answer
Does OPWDD cover a treatment my insurance refused?
Not automatically, and treatments that are experimental are separately excluded. A refusal from another payer changes what evidence exists; it does not by itself move a medical cost into a Self-Direction purchase.
Where this comes from
Kit quotes the governing document. OPWDD and your Fiscal Intermediary decide your request.