Better health for North Carolina’s children…

Peace of mind for their parents.

Health Check & N.C. Health Choice

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

North Carolina's Child 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 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

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

Sick Visits

Prescription 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.

Does my child 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. 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…

Be age 6 or older 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 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 feeFee 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 medicinesAll 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 visitsChildren 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-upsshotsregular teeth cleaning

How do I apply for Health Check & N.C. Health Choice?

To get an application:

Call the N.C Family Health Resource Line1-800-367-2229 (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 doctorEvery child needs a “Medical Home.”

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

Call the doctor anytimeWhenever you have questions about your child’s health

Read your benefits handbookIt 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.