Health Check (Medicaid) and N.C. Health Choice Better health for North Carolina’s children… Peace of mind for their parents. Why is 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… 20% have untreated vision problems 1 in 5 parents of uninsured children keep their kids from playing sports due to fear of injury Why is outreach 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 N.C.’s children’s health insurance programs North Carolina has two health insurance programs for children: Health Check (Medicaid for Children) N.C. Health Choice • Both are similar in what they offer • The same application is used to determine eligibility for both programs • They are marketed together Why market the two programs together? Children may 200% ($41,300)* cross over from Health Check to NC Health NC Health Choice as they age. Choice Income Guidelines Poverty Level (%) Families may have children in 100% ($20,650)* different programs. As a family’s Health Check income changes, Income Guidelines their children may as of April 1, 2007 *Annual go back and forth income for a family of 4 between programs. 0 1 6 18 Age (years) Does your child have health insurance? Does your child have health insurance? North Carolina offers two health insurance programs for children: Health Check (Medicaid for Children) N.C. Health Choice Free or low cost insurance for children and teens. What are the benefits? Well Child Checkups Lab Tests Sick Visits Counseling Prescription Medicines Medical Equip & Supplies Immunizations Hospital Care Vision & Hearing Care Therapies Dental Care Surgery Additional benefits may be available for children with Special Health Care Needs. Call 1-800-737-3028 for more information. Does my child qualify? Income guidelines* (valid 4/1/07 – 3/31/08) Family Size Monthly Income 2 $2,282 3 $2,862 4 $3,442 5 $4,022 6 Add $580 for each additional family member. *Income before taxes. Children of families who earn more may qualify if they have daycare, 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… For NC Health Choice, Be age 6 or older and under age 19 a child must: 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 they qualify 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 copays How much does coverage cost? N.C. Health Choice: Annual enrollment fee Fee depends on the family’s income. Some families have NO annual enrollment fees Some families pay a yearly fee of $50 for one child or $100 for 2 or more children. How much does coverage cost? N.C. Health Choice: Copays for medicines All children have copays for prescription drugs: $1 for generic drugs $1 for brand-name drugs that have no generic substitute $3 or $10 (depending on the family’s income) for brand-name drugs How much does coverage cost? N.C. Health Choice: Copays for some visits Children who pay an annual enrollment fee have small copays for some services: $5 for office visits $20 for non-emergency visits to the ER BUT, parents NEVER have a COPAY for check-ups shots regular teeth cleaning How do I apply for Health Check (Medicaid)/N.C. Health Choice? To get an application: Call the N.C Family Health Resource Line 1-800-367-2229 (1-800-FOR-BABY) Go online to www.nchealthystart.org, Visit “FOR THE PUBLIC” and look for “Child Health Insurance.” Pick up a form at your Dept. of Social Services or local Health Department If I need help with the application? If you need help filling out the application, visit your local Department of Social Services. They can answer your questions and take your application when it’s complete! Once the application is complete Mail or take the application to your local Department of Social Services Be sure to attach your wage stubs (proof of income for the previous month) Include proof of citizenship and identity for citizen children (e.g. copy of birth certificate and photo ID card). DSS can help. Include a phone number where you can be reached! How will I know if my child is covered? Social Services will notify you by mail. It can take up to 45 days to hear from Social Services. Be sure to tell them if you move or change phone numbers. You will get an insurance card & benefits booklet in the mail. Make the most of your child’s health insurance! Choose a doctor Every child needs a “Medical Home.” Make an appointment for a checkup Then you will have a trusted place to go when your child is sick. Call the doctor anytime Whenever you have questions about your child’s health Read your benefits handbook It has lots of information on benefits and resources. Stay Enrolled! Remember to RE-ENROLL each year! Look for your re-enrollment packet in the mail. Be sure to let your local Department of Social Services know if you move! Better Health for Your Children. Peace of Mind for You.
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