Transcript Slide 1

Health Check / NC Health Choice:
Keeping Students Healthy,
In School and Ready to Learn
Health Check / NC Health Choice
Orientation for School Health Advisory Councils,
School Nurses and Student Support Services Professionals
Why is it important for School Health
Advisory Councils, School Nurses &
Student Support Services Professionals
to promote child health insurance?
School staff struggle to address the complex needs of their
students (risk prevention; primary care; behavioral-mental
health; nutritional; dental; reproductive).
Access to health insurance plays a key role in students
receiving the community resources and services needed.
As you objectively assess the needs of young people in
your community, consider the impact that being uninsured
has on a student’s ability to be healthy and ready to learn.
Why is it important for
children to be insured?
Compared to insured children, uninsured children are:
25% more likely to miss school
8X less likely to have a regular source of care
4X more likely to delay or avoid care when needed
5X more likely to seek care from an emergency room
7X more likely not to have prescriptions filled
In addition…
20% have untreated vision problems
1 in 5 parents of uninsured children keep their kids from playing
sports due to fear of injury
Research data compiled by the RWJF Covering Kids Project.
What do we know about
uninsured children in North Carolina?
Employer-sponsored health insurance coverage for dependents (children
under 18 years old) continued to decline in 2007-08 to 49.8% of all children.
Loss of employer-sponsored coverage is due to:
Erosion of health insurance benefits offered by small businesses due to cost.
Spiraling cost of family coverage. [Premiums increased 119% between 1999 and
2008 compared to 34% for wages and 29% for overall inflation].
And, to a lesser degree, due to loss of manufacturing jobs & transfer of employees
to service sector with less benefits.
The current economic climate is further contributing to the number of uninsured
families in North Carolina
[Sources: Kaiser Family Foundation: State Health Facts, based on the Census Bureau's March 2008 and 2009 Current Population
Survey & NC Institute of Medicine].
Children have been impacted by loss of employer-sponsored coverage more
than any other age group (11.3% of NC children are uninsured).
Of the 270,000+ uninsured children in NC, 68% qualify for NC’s publiclysponsored child health insurance programs based on income.
[Source: Kaiser Family Foundation: State Health Facts, based on the Census Bureau's March 2008 and 2009
Current Population Survey & NC Institute of Medicine for % qualifying for HC/NCHC].
Why is outreach for child health
insurance important?
60% of parents with uninsured children who qualify
don’t believe they do
71% of parents in eligible households where both
parents work do not believe their children would qualify
Of these parents (listed above), 82% said they would
enroll if they knew they were eligible
Wirthlin Worldwide - Research Firm
What child health insurance programs
does North Carolina offer?
North Carolina offers two health insurance
programs for children:
Health Check
(Medicaid for Children)
N.C. Health Choice
(Federal Name is CHIP)
– Both offer free or low cost health
insurance for children and teens.
– The same application is used to
determine eligibility for both programs.
– They are marketed together.
– Children are enrolled in the program
they qualify for.
– Both programs are funded by a
combination of federal and state dollars.
– Medicaid is an entitlement program; NC
Health Choice is an optional program.
Why market the two programs together?
200% ($44,100)*
NC Health
Choice
Poverty Level (%)
Income Guidelines
100% ($22,050)*
Family doesn’t know
what program they
will qualify for until
they apply.
Children may cross
over from Health
Check to NC Health
Choice as they age.
Families may have
children in different
programs.
Health Check
Income Guidelines
*Annual
income for a
family of 4
as of April 1, 2009
0
1
6
Age (years)
18
As a family’s income
changes, their
children may go
back and forth
between programs.
What are the benefits?
Well-child Checkups
Sick Visits
Medicines
Immunizations
Vision & Hearing Care
Dental Care
Lab Tests
Counseling
Medical Equip & Supplies
Hospital Care
Therapies
Surgery
Additional benefits may be available for children with Special Health Care Needs.
Call 1-800-737-3028 for more information.
How can a family determine if their
child is likely to qualify?
Income guidelines* (Valid 4/1/09 – 3/31/10)
Family Size
Monthly Income Before Taxes*
2
$2,429
3
$3,052
4
$3,675
5
$4,299
6
Add $624 for each additional family member.
*Children from families who earn more may qualify if they have child
care, work-related or child support expenses.
In addition…
For both programs,
a child must:
Be a N.C. resident
Be under age 19 (21 in
some cases)
Be eligible based on family
income
Provide or apply for a
Social Security number
And, for children who are
U.S. citizens, provide
documentation of
citizenship and identity.
And…
For NC Health Choice,
a child must:
Be over age 6 and under age 19
Be income ineligible for
Health Check (Medicaid)
Be uninsured on the day coverage
starts (your local Department of Social
Services can give you more
information)
Have paid the N.C. Health Choice
enrollment fee, if required
Is a child of immigrant parents eligible?
Yes, if the child is born in the USA and they qualify based on the
family’s income and residency status.
– A social security number must be provided for the child or proof that a social security
number has been requested.
Maybe, if the child was born abroad.
It depends on the immigration status of the child. Check with the local Department of
Social Services to find out.
Note: Parents DO NOT hurt their chances for naturalization by applying for
children’s health insurance!!
How much does coverage cost?
Health Check (Medicaid):
No annual enrollment fee
No co-pays
N.C. Health Choice:
Annual enrollment fee depends on the
family’s income.
Some families have NO annual enrollment fee
Some families pay $50 per child or $100 for 2 or more children
Co-pays depend on the family’s income.
$1, $3 or $10 for prescription drugs-depending on whether a generic or brand-name
drug is prescribed
$5 for office visits
$20 for non-emergency visits to the ER
Families who have NO annual enrollment fee also have no co-pays except for a
small prescription drug co-pay.
Parents NEVER have a CO-PAY for
check-ups
shots
regular teeth cleaning
How can a family obtain an application for
Health Check (Medicaid)/NC Health Choice?
To get an application, families can:
Go online to www.NCHealthyStart.org.
Visit the “FOR THE PUBLIC” section and click on the
“Child Health Insurance” link
Pick up a form at the local Department of Social
Services or Health Department
What if the family needs help filling
out the application?
If the family needs help filling
out the application, encourage
them to visit their local
Department of Social Services.
DSS can answer the family’s
questions and take their
application when it is complete!
What if the family completes the
application on their own? Then what?
Families can mail or take the application to
their local Department of Social Services.
Remind them to:
Attach copies of wage stubs or proof of income
for the previous month. Unemployed
individuals need to note this on the application
form in the income section.
For children who are U.S. Citizens, the DSS
will also need proof of their citizenship and
identity (for example, copy of birth certificate
and school, medical or hospital record with the
child’s name and birth date). The DSS can
help families verify citizenship and identity.
Include a phone number where the DSS
worker can call if they have a question!
Social Services will notify the family by mail
to let them know if they qualify. This can take
up to 45 days.
If they qualify they will get an insurance card
and benefits booklet in the mail.
How can a family benefit the most from
their child’s health insurance coverage?
Encourage families to:
Choose a doctor
Every child needs a “Medical Home.”
The doctor can help parents coordinate the care
needed by their children.
Make an appointment for a checkup
Then they will have a trusted place to go when
problems arise.
Call the doctor anytime
Whenever families have health-related questions.
Read the benefits handbooks
They are available online at the
www.NCHealthyStart.org Child Health Insurance
Web Site. The books have lots of information
about benefits and resources.
Help families stay enrolled!
Remind families that they must RE-ENROLL each year!
A re-enrollment packet will arrive in the mail.
Families must let their local Department of Social
Services know if they move!
How Can School Health Advisory Councils, School
Nurses & Student Support Services Staff Help?
What Resources Are Available?
How Can School Health Advisory Councils, School
Nurses & Student Support Services Staff Help?
As a group, become familiar with the state’s child health insurance programs.
A School Partnership Page will link you to an orientation PPT and the materials/ resources
needed to help families learn about and apply for these programs.
(http://www.nchealthystart.org/outreach/SchoolPartnership/index.htm )
Objectively assess the needs of young people in your community. Consider the data
on uninsured children and the impact that has on students being healthy and ready to learn.
Review the handout with the "menu of strategies." Build on existing infrastructures to
insure kids now. Add your local creative ideas to the list.
Choose a strategy or strategies that you feel will have the greatest success in your
community.
Consider becoming a “pilot site” for implementing a child health insurance outreach
initiative in your school or school district. Contact Carolyn Sexton at 919-707-5642 or
[email protected] for help linking with state and local resources.
For LEAs involved in Healthy & Ready to Learn, contact Ania Boer at 919-839-1156 or
[email protected] OR you may go to www.ncpedsfoundation.org for further information
about this outreach initiative.
Share lessons learned from your efforts. We would like to highlight your success stories
on our School Partnership Web page, in presentations to the NC Coalition to Promote
Health Insurance for Children and at a future NC Healthy Schools Institute.
What Resources Are Available?
North Carolina Healthy Start Foundation
Campaign and Materials Development
Bilingual (English/Spanish) envelope stuffers, fact sheets, posters, and
application forms are available free of charge!
Materials can be ordered online, by fax or by mail.
Go to the NCHSF Web site at www.NCHealthyStart.org & click on the
“Order” link. Save this link on your desktop so it is easy to reorder at
any time.
Fact sheets are now available online for 6 additional populations:
Arabic; Chinese; Hmong; Korean; Rhade (for Montagnard); Vietnamese.
What resources are available?
CARE-LINE
1-800-662-7030
Open 7 am-11 pm, 7 days a week including state holidays.
NC Department of Health and Human Services’
Toll-Free Information and Referral Line
Provides information & referrals regarding human services offered by government and nonprofit agencies including NC’s child health insurance programs..
Offers statewide coverage for all 100 counties.
Maintains the NCcareLINK database of 10,000+ services and provides direct access to NC
residents and professionals ( https://www.nccarelink.gov/ ).
What Resources Are Available?
Children with Special Health Care Needs Help Line
1-800-737-3028
For families of children with special health care needs
and for health professionals:
Educates about Health Check / Health Choice, particularly the insurance benefits
Provides information and referrals to other state and local resources
Links to providers/ specialists
Helps families problem solve
For More Information
For Questions / Information about State Outreach Activities:
Carolyn Sexton: 919-707-5642 or [email protected]
For Questions about Ordering Materials:
NC Healthy Start Foundation: 919-828-1819
For Assistance in Planning Outreach to Minority Populations:
Norma Marti: 919-707-5643 or [email protected]
For Questions / Information about the NC Pediatric Society Foundation’s
Healthy & Ready to Learn Initiative:
Ania Boer: 919-839-1156 or [email protected]
Or go to www.ncpedsfoundation.org
For More Information
A "School Partnership Page" offers a one-stop-shop for everything
folks need to help with child health insurance outreach:
http://www.nchealthystart.org/outreach/SchoolPartnership/index.htm
Provides links to:
School-Based Child Health Insurance Outreach "Menu of Strategies"
Tools to Support Implementation of the "Menu of Strategies"
Health Check / NC Health Choice Orientation PPT
NC Healthy Start Foundation Online Catalog
NC Healthy Start Foundation Online Order Form
HC/NCHC Application in English
HC/NCHC Application in Spanish
List of Local DSS Addresses & Phone Numbers
Directory of Regional Health Check Coordinators
Child Health Insurance Web Page (For the Public)
NC Pediatric Society Foundation’s Healthy & Ready to Learn Initiative Web Page
Note: Save this link on your desktop & you will have
easy access to everything needed!
THANK YOU
for giving families peace of mind by helping them
enroll their children in health insurance!