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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?.
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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? • 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. 200% ($44,100)* 100% ($22,050)* *Annual income for a family of 4 Poverty Level (%) NC Health Choice Income Guidelines Health Check Income Guidelinesas of April 1, 2009 0 1 6 18 Age (years)
Well-child Checkups Sick Visits Medicines Immunizations Vision & Hearing Care Dental Care Lab Tests Counseling Medical Equip & Supplies Hospital Care Therapies Surgery What are the benefits? 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) *Income before taxes. Youth from familieswhoearn 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.
And… • Be over age 6 and underage 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 For NC Health Choice, a child must:
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 Line1-800-367-2229 (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!
How can ESC staff help? For All Local ESC Staff: • Become familiar 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 information. • 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 mail 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 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 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 Diane.G.Smith@ncmail.net For Questions About Health Check / NC Health Choice: • Carolyn Sexton: 919-707-5642 or Carolyn.Sexton@ncmail.net • Local Health Check Coordinator For Questions About Ordering Materials: • Ania Boer: 919-828-1819 or Ania@NCHealthyStart.org
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 YOUfor giving families peace of mind by helping them enroll their children in health insurance!