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There's no excuse NOT to have health insurance
for your child!
The importance of having health insurance
for you and your child cannot be overestimated. There is a health
insurance plan for every family, no matter what your income level
may be. There are many types of health insurance, and what works
well for one family may not work for another. Your health insurance
needs may change, too, as your situation changes. When choosing
a plan, there are some basic words and phrases to be aware of, but
the best description of services is from your insurance provider
itself.
What types of health insurance plans
are there?
- Group insurance vs. individual insurance
Group insurance is generally the most inexpensive kind and is
usually through your employer. Individual insurance is for those
who do not get insurance through work or have only limited coverage.
- Fee-for-service
With a fee-for-service plan, insurance companies pay fees for
the services used by people covered by the policy. This policy
allows you to choose what doctors and hospitals you would like
to use, but you are also expected to keep track of your medical
receipts, which you submit to your insurance company for compensation.
- Health Maintenance Organizations (HMOs)
HMOs are prepaid health plans. In exchange for a monthly payment,
you receive healthcare, such as well-baby visits, hospital emergencies,
and x-rays. In most HMOs, you have a list of doctors who are members
of that HMO that you can choose from. HMOs will not pay if you
go to a doctor who is not on the list or go to a specialist without
a referral.
- Preferred Provider Organizations (PPOs)
PPOs are a combination of fee-for-service and HMO plans. Like
an HMO, PPOs use certain doctors who they prefer you to go to.
When you use the preferred doctors, the PPO pays most of the bill.
However, if you go to a doctor who is not part of the network,
you will still be covered, but you will have to pay a larger part
of the bill yourself and fill out the claims forms.
- Medicaid
Medicaid is an insurance program through the federal government
that helps low-income people afford medical care.
- Medicare
Medicare is also a federal program, but it is specifically for
Americans over 65 or for people with certain disabilities.
- State Children's Health Insurance Program
(SCHIP)
SCHIP provides health insurance for children in families whose
income is too high to qualify for Medicaid, but who do not have
private coverage. Through the Insure Kids Now program every state
in the nation has a health insurance program for infants, children
and teens. The insurance is available to children in working families,
including families that include individuals with a variety of
immigration status. For little or no cost, this insurance pays
for doctor visits, prescription medicines, hospital visits, and
more. For more information call 1-877-KIDS-NOW or visit http://www.insurekidsnow.gov/states.htm
to find out about your state's program.
You have insurance, now what?
Way to go! You are on the right track to giving
your child a healthy start in life and are planning for the future.
The next step is to make your insurance work for you. Contact your
health insurance provider to make sure that you know what services
are covered, what limitations there may be, which doctors and hospitals
you can use, and what the fees are. Children with special needs may
require a different type of coverage than other children, so be sure
you understand what your policy offers. While contacting your insurance
company will help you get answers to specific questions, these web
sites can also answer some basic questions about health care plans.
American Academy of Family Physicians answers questions
about your health insurance coverage on this web site.
http://familydoctor.org/handouts/688.html
American Academy of Pediatrics answers questions
about managed care for you and your children on this web site.
http://www.aap.org/family/mancarbr.htm
Family Voices, a "national, grassroots clearinghouse for information
and education concerning the health care of children with special
health needs" has a web site that answers questions about managed
care and how it affects children with special needs. http://www.familyvoices.org/Information/msdiscussion.htm
National Health Law Program has a web site
devoted to issues such as immigrant health, children and Medicaid,
and reproductive health. This link will take you to user-friendly
fact sheets on managed care.
http://www.healthlaw.org/pubs/FS/managedcarefacts.shtml
If you do not have insurance, why wait
any longer?
Making sure that your child has health insurance
must be a priority for every parent. Below are links to health insurance
opportunities for all types of families.
Centers for Medicare and Medicaid Services web site
has easy-to-understand explanations of basic Medicare and Medicaid
coverage, a glossary, and links to resources for families with children.
http://cms.hhs.gov/consumers/
State Children's Health Insurance Program (SCHIP):
Insure Kids Now!
Through Insure Kids Now! every state in the nation has a health
insurance program for infants, children and teens. The insurance
is available to children in working families, including families
that include individuals with a variety of immigration status. For
little or no cost, this insurance pays for doctor visits, prescription
medicines, hospital visits, and more. For more information call
1-877-KIDS-NOW or visit http://www.insurekidsnow.gov/states.htm
to find out about your state's program.
Centers for Medicare and Medicaid Services web site
has easy-to-understand explanations of basic Medicare and Medicaid
coverage, a glossary, and links to resources for families with children.
http://cms.hhs.gov/consumers/
The healthfinder® web site, developed by the
U.S. Department of Health and Human Services together with other
Federal agencies, has many links that will help you search government
and nonprofit health and human services information on the web,
including many sites for Medicaid and other insurance policies.
http://www.healthfinder.gov/scripts/SearchContext.asp?topic=530&Branch=3
Kaiser Family Foundation State Health Facts Online
is a web site of state-by-state fact sheets and data for topics
such as number of HMOs, health plan liability, managed care and
health insurance, women's health, and more.
http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi
To find information on the health care programs
and services available to you and your family, visit the Family
Voices in SCHIP web site.
http://www.familyvoices.org/SCHIP/Fall2003_Update.htm
Through the Hill-Burton program of the Health Resources
and Services Administration (HRSA) Program, you may be able to obtain
free care. See this web site for details or call 1-800-638-0742.
http://www.hrsa.gov/osp/dfcr/obtain/obtain.htm
Children with special health needs
The Family Voices site has questions to ask and answer when looking
for the right health care for you and your child with special needs.
They also have an information sheet for parents on managed care
plans for special needs children.
http://www.familyvoices.org/YourVoiceCounts/home.htm
http://www.familyvoices.org/Information/mcabcs.htm
The Family Voices homepage can also link you to
other valuable resources for taking care of a child with special
needs.
http://www.familyvoices.org/
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