Do children in the families you serve have

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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
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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.

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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 dont believe they do
• Of these parents, 82 said they would enroll if
  they knew they were eligible
• Wirthlin Worldwide - Research Firm

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Do I need to be an expert to promote NCs 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.

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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

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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 familys income changes, their children may
  go back and forth between programs.

200 (44,100) 100 (22,050) An
nual 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)
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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.
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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 families who
earn more may qualify if they have child care,
work-related or child support expenses.
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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.

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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
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Is a child of immigrant parents eligible?

• Yes, if the child is born in the USA and
  qualifies based on the familys 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 childrens health
  insurance!!

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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
• familys 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 familys 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.

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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 childrens health insurance link
• Pick up a form at their local Department of
  Social Services or Health Department

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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 familys questions and take
  their application when it is complete!

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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.

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How can a family make the most of their childs
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 childs
  health
• Read their benefits handbook
• It has lots of information on benefits and
  resources.

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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!

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So How can ESC staff help? What
resources are available?
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How can ESC staff help?

• For All Local ESC Staff
• Become familiar with the states 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 states 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!

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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.

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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.

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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

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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

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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_at_ncmail.net
• For Questions About Health Check / NC Health
  Choice
• Carolyn Sexton 919-707-5642 or
  Carolyn.Sexton_at_ncmail.net
• Local Health Check Coordinator
• For Questions About Ordering Materials
• Ania Boer 919-828-1819 or Ania_at_NCHealthyStart.or
  g

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For information and to order materials

• To learn more about North Carolinas 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/individ
  ual/resources/resourcesmain.asphealth .
• This links directly to the NC Healthy Start
  Foundations For the Public-gtChild Health
  Insurance Web page at http//www.NCHealthyStart.o
  rg/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.

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THANK YOU for giving families peace of mind by
helping them enroll their children in health
insurance!