Transcript Slide 1
Do children in the families you serve have health insurance?
Health Check / NC Health Choice
Orientation for Employment Security Commission Staff
Why is it important for ESC staff to promote child health insurance?
YOU know how stressful it is for families when a parent loses his/ her job.
YOU play an important role in helping families access needed resources.
YOU know that when a parent becomes unemployed, families frequently lose health insurance coverage.
Now YOU can give families peace of mind by helping to enroll their children in health insurance.
Why is outreach for child health insurance important?
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, according to research* done in North Carolina: 60% of parents with uninsured children who qualify don’t believe they do Of these parents, 82% said they would enroll if they knew they were eligible *Wirthlin Worldwide - Research Firm
Do I need to be an expert to promote NC’s child health insurance programs?
No. Families just need to know that North Carolina offers two child health insurance programs.
A simple handout (an “envelope stuffer”) helps families determine if they qualify and provides a Web site and toll-free number for more information.
This presentation provides a brief overview of the child health insurance programs to make you feel more comfortable in your outreach role.
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
– 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
Why market the two programs together?
NC Health Choice
Income Guidelines
Health Check
Income Guidelines as of April 1, 2009 0 1 6 18 Age (years) 200% ($44,100) * 100% ($22,050) * * Annual income for a family of 4 Children may cross over from Health Check to NC Health Choice as they age.
Families may have children in different programs.
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 2 3 4 5 6 Monthly Income $2,429 $3,052 $3,675 $4,299 Add $624 for each additional family member.
*Income before taxes. Youth 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 U.S. Citizens, provide documentation of citizenship and identity.
For
NC Health Choice
, a child must:
And…
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 Service 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 qualifies based on the family’s income.
– The child will need a Social Security Number to apply.
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, they can: Call the N.C Family Health Resource Line
1-800-367-2229
(1-800-FOR-BABY) Go online to www.NCHealthyStart.org
.
Visit the “FOR THE PUBLIC” section and look for the “free or low-cost children’s health insurance” link Pick up a form at their 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.
Include proof of citizenship and identity (e.g. birth certificate; ID card) for citizen children who are applying. Bring original documents if apply in person; “copies” of original documents if applying by mail.
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 make the most of their child’s health insurance?
They can: Choose a doctor Every child needs a “Medical Home.” Make an appointment for a checkup Then they will have a trusted place to go when their child is sick.
Call the doctor anytime Whenever they have questions about their child’s health Read their benefits handbook It has lots of information on benefits and resources.
Encourage families to 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!
So… How can ESC staff help? What resources are available?
How can ESC staff help?
For All Local ESC Staff: Become familiar
information.
with the state’s child health insurance programs. You do not have to be experts! We just want you to be comfortable promoting Health Check and NC Health Choice. Others are standing by if families have questions or need more
Display the Health Check/NC Health Choice Posters
(mailed to you earlier) near your Information Desk or in the Unemployment Waiting Area.
For Unemployment Insurance Workers: Inform families about the state’s child health insurance programs
at the initial benefits rights interview.
Distribute the “envelope stuffer”
to individuals who are interested. COBRA decisions to continue health insurance coverage must be made quickly. Family coverage may be prohibitively expensive. Knowing that there is an alternate option for covering kids may reduce their expenses and financial stress.
Refer families
who have questions or need more information to the toll-free line or Web site listed on the envelope stuffer. They can also go to the local DSS and apply in person!
How can ESC staff help?
For Employment Consultants: Helping families access resources
to support them through their unemployment crisis is a big part of what you do. Follow-up with families who have children to see if insurance is needed.
Keep a supply of envelope stuffers
on hand so that you can make applying for these programs easy.
Refer families
who have questions or need more information to the toll-free line or Web site listed on the envelope stuffer. They can also go to the local DSS and apply in person!
Display Health Check/NC Health Choice envelope stuffers
in ESC Resource Centers.
What resources are available?
North Carolina Healthy Start Foundation
Campaign and materials development
Bilingual (English/Spanish) envelope stuffers, posters, and application forms are available free of charge!
The fact sheets have been translated into 6 additional languages (Arabic, Chinese, Hmong, Korean, Montagnard, Vietnamese).
Materials can be ordered online, by fax or by mail. Go to the NCHSF Web site at www.NCHealthyStart.org
and click on the “Order” link.
A direct link from your ESC Staff Intranet site to the Order Form will be available soon.
What resources are available?
North Carolina Family Health Resource Line
Services in English and Spanish
For Health Check / NC Health Choice: Educates
about child health insurance programs Offers to
print materials/ application forms
Refers
families for local assistance
Helps families link
with health care providers
Advocates
for families who run into barriers
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
benefits about Health Check / Health Choice, particularly the insurance
Provides information and referrals
to other state and local resources
Links
to providers/ specialists Helps families
problem solve
For more information
For Questions About the Partnership Between the State Employment Security Commission, the Division of Public Health & the NC Healthy Start Foundation:
Diane G. Smith: 919-733-4896 or [email protected]
For Questions About Health Check / NC Health Choice:
Carolyn Sexton: 919-707-5642 or [email protected]
Local Health Check Coordinator
For Questions About Ordering Materials:
Ania Boer: 919-828-1819 or [email protected]
For information and to order materials
To learn more about North Carolina’s child health insurance programs, families and ESC staff may go to :
ESC Web Site ( http://www.ncesc.com
) and click on “Individual Services” and then under “Other Resources”, click on “Health”, and then “Child Health Insurance”. OR you can bookmark: http://www.ncesc.com/individual/resources/resourcesmain.asp#health . This links directly to the NC Healthy Start Foundation’s “For the Public”->”Child Health Insurance” Web page at http://www.NCHealthyStart.org/public/childhealth/index.htm
.
To order outreach materials and application forms, ESC staff may go to:
NC Healthy Start Foundation Web site at www.NCHealthyStart.org
. Click on “Order”. Soon there will be a link from your ESC Staff Intranet site to the Order Form and this PowerPoint Presentation.
THANK YOU
for giving families peace of mind by helping them enroll their children in health insurance!