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Healthy Kids in the CAP or Welfare Office Covering The Basics.

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Presentation on theme: "Healthy Kids in the CAP or Welfare Office Covering The Basics."— Presentation transcript:

1 Healthy Kids in the CAP or Welfare Office Covering The Basics

2 Uninsured children in the U.S. There are 315,000 children in NH. 72,000 of them are low income. 71 percent of uninsured children in the U.S. have family incomes below 200% of the FPL. The vast majority of uninsured children (88.2 %) come from families where at least one parent is working. 88 percent of all low-income uninsured children are eligible for Medicaid or CHIP (known as Healthy Kids in NH).

3 Children without insurance… are more than three times as likely to lack a regular source of health care more than four times as likely to have delayed medical care because of cost more than three times as likely to lack necessary dental care more than twice as likely to go without needed prescription medications and more than twice as likely to go without eyeglasses.

4 YOU are an important partner for covering kids The NHHK outreach strategy depends on our partnerships with communities Goal: make access to coverage available at the places uninsured families are already going

5 You can make a difference. Screen for health insurance status on intake forms Include NHHK materials and information in food baskets Send NHHK materials home in routine mailings to families Help enrolled families to stay enrolled; ask families with enrolled kids when their renewal date is, and offer help completing the renewal forms Learn about our income guidelines and share them with families who may be eligible Did you know? Families who ONLY want to apply for Healthy Kids (and no other state programs) DO NOT NEED to go to a District Office to apply!

6 Healthy Kids: The Basics Families apply for coverage by completing an application NHHK staff review the application to be sure it is complete. Families with incomplete applications are given extra help to finish the process Completed applications are passed on to DHHS, who determines which program the child is eligible for The child is enrolled in coverage (automatically for Gold kids, a separate process for Silver/Buy-In) The family must complete an annual renewal to maintain coverage

7 Healthy Kids Gold Coverage for children and pregnant woman at no cost to the family. Infants up to the age of one are eligible at higher income levels. State run, fee for service program. Doctors and Dentists Care is provided by doctors, dentists, and health care providers who contract with DHHS. Cost No cost to families Healthy Kids Silver Low-cost coverage for children who have been uninsured for six months prior to enrollment. Coverage is provided through a managed care plan from Harvard Pilgrim and Northeast Delta Dental Doctors and Dentists The Harvard Pilgrim and Delta Dental network of providers are available to enrolled children. Cost Monthly premiums are $32 or $54 depending on income and family size. Healthy Kids Buy-In Unsubsidized coverage for children who do not qualify for Gold or Silver. Benefits are the same as the Healthy Kids Silver program. Some of the co- pays may differ from the Silver program. Doctors and Dentists The Harvard Pilgrim and Delta Dental network of providers are available to enrolled children. Cost Monthly premiums are $205 per child, per month. Healthy Kids: The Programs

8 Healthy Kids: Eligibility Age: Must be under the age of 19 or pregnant women of any age Citizenship: Must be a US citizen, refugee, asylee or a permanent resident for at least five consecutive years Residency: Must be a NH resident Income: Total family income must fall within current guidelines Insurance Status: Must be uninsured for six consecutive months to be eligible for HK Silver or have lost insurance due to certain good causes, such as job loss.

9 Healthy Kids: Income Guidelines Some expenses, such as child care, may be deducted from your income. If your income is above, but close to these limits, you may be eligible. Income levels are subject to change. The Healthy Kids Buy-In program receives no State or Federal funds.

10 Healthy Kids: How to Apply For families not receiving other state assistance: –Visit to complete a printable application –Call us at 1-877-464-2447 for help applying over the phone –In person with a trained application assistor (available in most communities) –In person at 1 Pillsbury Street, Suite 300 in Concord, Monday- Friday 8am-4:30pm. No appointment is necessary! –Help the family complete a Health Insurance Status Release Form and submit it to our office For families currently receiving other state assistance: –Contact the local District Office (call us at 1-877-464-2447 to find out where the District Office is located)

11 How to determine the status of an application Ask the family, “where did you apply?” and “are you receiving any other state assistance like cash or food stamps?” If the family applied at a District Office OR if they are receiving other state programs, call the District Office. If the family MAILED their application OR applied on Pillsbury Street in Concord and they’re NOT receiving other state programs, call our office at 1-877-464- 2447. You will need the family with you OR a signed release form to get information about their case.

12 Helpful Tools New website –Health insurance release of information form –Income guidelines –Benefits information –Printable application Local application assistors

13 Questions and Answers

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