Transcript Tampa Bay KidCare Outreach Project

Florida ranks 3rd in U.S. for the number of uninsured children.
• 42% of Florida’s children live in families 200% under FPL
• 40% of these are uninsured
Florida ranks second in the nation for the percentage of
children in the state without
health insurance.
• 70% of uninsured children are eligible for CHIP
But…
Many parents do
not realize their
children are
eligible!
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Anyone can get coverage in Florida KidCare
It is what you pay that varies from family to
family
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Was created by the 1998 Florida Legislature
in response to SCHIP legislation
SCHIP is a federal/state matching funds
program
Affordable health insurance for Florida’s
children
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Be uninsured
Under age 19
Currently reside in Florida
Be a U.S. citizen or qualified non-citizens
Non-citizens qualify for full pay
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Eligibility for the Florida KidCare program is
based on family size and household income.
Those families with incomes under 200% of the
Federal Poverty Level (FPL) may be eligible for
subsidized health coverage.
Families over 200% FPL are eligible for coverage
at full pay rate.
Medicaid
CMS
MediKids
Florida
Healthy KidsKids
Florida
KidCare
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Children’s Medicaid – Children from birth
through 18 years; no premiums or copayments
Medikids – Children 1 through 4 years that
are not Medicaid eligible; $15-$20 per month
per family – Full Pay $196 per month per
child. No co-pays.
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Florida Healthy Kids – children 5 through 18 that
are not Medicaid eligible; $15-$20 per month
per family – Full pay $133 per month per child
with dental, $121 per month per child without
dental. Small co-pays.
Children’s Medical Services Network CMSN –
children from birth through 18 years who have
special health care needs, or ongoing medical
conditions including behavioral health.
Family Size
100% of
Poverty
133% of
Poverty
150% of
Poverty
200% of
Poverty
1
$11,170
$14,856
$16,755
$22,340
2
$15,130
$20,122
$22,695
$30,260
3
$19,090
$25,389
$28,635
$38,180
4
$23,050
$30,656
$34,575
$46,100
5
$27,010
$35,923
$40,515
$54,020
6
$30,970
$41,190
$46,455
$61,940
7
$34,930
$46,456
$52,395
$69,860
8
$38,890
$51,723
$58,335
$77,780
MediKids
Full Pay
>200%
$196 per
month per
child
Florida Healthy Kids Full Pay > 200%
$133 per month per child - $121 without dental
200%
Federal Poverty Level
185%
MediKids
(AHCA)
Florida Healthy Kids
(Title XXI Administration/Enrollment,
3rd Party Administrator Contract)
133%
100%
Medicaid for Children
(DCF, Eligibility; AHCA, Program Administration)
Ages 0
to 1
Ages
1 through 4
Age 5
Ages 6 through 18
Medicaid:
Title XIX-Funded
Title XXI-Funded
CMS Network
Title XIX and Title XXI
(Dept. of Health)
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Doctor’s Visits
Immunizations
Hospital Visits
Prescriptions
Dental Care
Vision Care
Emergencies
And Much More
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Mail
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Fax
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E-mail application as a second document
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Online: floridakidcare.org
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Proof of all sources of household income
Child’s Social Security number or the date you
applied for it
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Amount of daycare payments
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Birth Certificate of children you are applying for
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Identification for child 16 or older
Wages & Salaries
• Pay stubs (4 wks)
• Tax return
• W2 Form
• Wage Statement
• Employer Letter
Self Employment Income
• Business Ledger
• Receipts
• Tax Statement
• SSN #
Child Support Received
Unearned Income
• Social Security Benefits
• Disability Benefits
• Unemployment
• Pensions
• Workers’ Compensation
• Veteran's Benefits
Subsidized
premium
assistance:
• Cost of insurance was more than
5% of family’s income
• Lost of job that provided
insurance
• Employer canceled insurance
• Canceled COBRA coverage or
COBRA reached legal limit
• Non-custodial parent canceled
coverage
Subsidized
premium
assistance:
Child has a medical condition that without
medical care could cause serious disability,
loss of function, or death
Insurance does not cover health care needs
Coverage ended due to child reaching
maximum lifetime limit or annual benefit
Domestic violence led to loss of coverage
If insurance was cancelled in the last two
months and the family does NOT qualify for
subsidized premium assistance, family can
still apply for Full Pay Coverage.
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Non-Citizen Children
Qualified Non-citizens
Immigration Status
Florida KidCare does not ask about parent’s immigration status
Social Security Information
Child’s social security
number is required-Not
parents
Parents need to provide SSN
application date
A SSN application
confirmation letter
• Florida KidCare On-line Account
• https://www.healthykids.org/account/
• Florida KidCare Information Line
(888) 540-5437
• General information
• Florida KidCare Customer Service
(800)821-5437
• Status of an application
• Existing Florida KidCare account
•
Medicaid Florida KidCare Customer Service
(800) 352-5437
floridakidcare.org
Internet & Telephone
• 24 hours a day, 7 days a week
• Visa, MasterCard and Discover accepted
• Direct from checking or savings account
•
Fee may be charged
Mail
• Mail a check or money order with payment coupon to
Florida KidCare
• Write your family account number on check or money order
Cash Payments
• 600 Fidelity Locations
• $2.00 Service Fee
Text message Payments
• Need to sign up
• Only set for monthly payments; not extra payments
Not making a payment will result in a
cancellation of coverage
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Nonpayment cancelation: Cannot reactivate for coverage for one
month (30 Days)
Enrollees have 10 working days to request a dispute resolution &
benefits reinstated
12 Month Renewal
Notification
Family Check List
Pre-populated forms
to review
Letter in mail 2
months prior to
renewal date
Current Pay Stubs
(covering the last 4
weeks)
Need to update
income verifications
Important to respond
ASAP to letter
Your family's most
recent tax return (Form
1040)
Non-renewal of coverage means
the loss of health insurance
benefits!
Your Wage and Earning
Statement (W-2 Form)
Funding Provided By
 Healthy Kids Corporation
 The Kids Healthcare Foundation
Staffing Provided By
 St. Joseph’s Children’s Hospital Child
Advocacy Center
◦ Application Assistance
◦ Community Partners
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Assist family in completing the application
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Fax documentation
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Help families navigate the Florida KidCare
system
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Answers questions
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Enrollment events at companies
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Michele Pernula
Program Coordinator
Tampa Bay KidCare Outreach Project
St. Joseph’s Child Advocacy Center
1401 A E. Fowler Avenue
Tampa, FL 33612
863-660-3047
[email protected]