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because they have enacted State statutes providing the requisite protections. That is, as required by

§303.520(b), the State legislation ensures that the use of

private health insurance to pay for Part C services would not: (1) count towards or result in a loss of benefits due to the annual or lifetime health insurance coverage caps for the infant or toddler with a disability or family, (2) negatively affect the availability of health insurance for the child and family, (3) result in the discontinuation of health insurance coverage, or (4) be the basis for increasing the private insurance premiums for the child or family. In States without these statutes, it is unlikely that these States are accessing private insurance to any significant extent without parental consent.

Part C services must be provided free of charge unless the State has established a system of payments. States

wishing to use a parent’s or child’s private insurance

funds to pay for Part C services should have already included this option in a system of payments, especially in cases where the use of private insurance involves co- payments and deductibles. Even in cases where the State might be willing to cover the up-front costs (e.g., the co- payment) in order to obtain parental consent to use private insurance, the State could not have done so without access