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 school8X less likely to have a regular source of care4X more likely to delay or avoid care when needed5X more likely to seek care from an emergency room7X 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 doOf 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 0 1 6 18

Age (years)

Health Check Income Guidelines

as of April 1, 2009

Pov

erty

Lev

el (

%)

NC Health Choice

Income Guidelines

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?

Family Size Monthly Income

2 $2,429

3 $3,052

4 $3,675

5 $4,299

6 Add $624 for each additional family member.

Income guidelines* (valid 4/1/09 – 3/31/10)

*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.

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

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 feeNo co-pays

N.C. Health Choice:

Annual enrollment fee depends on the family’s income.

Some families have NO annual enrollment feeSome 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-upsshotsregular 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 doctorEvery child needs a “Medical Home.”

Make an appointment for a checkupThen they will have a trusted place to go when their child is sick.

Call the doctor anytimeWhenever they have questions about their child’s health

Read their benefits handbookIt 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 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 FoundationCampaign 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 EmploymentSecurity Commission, the Division of Public Health & the NC HealthyStart 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.netLocal 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 YOU for giving families peace of mind by

helping them enroll their children in health insurance!