Health Plans for Kids – S3 E2

[00:00:00] Jessica Stewart-Gonzalez: Welcome to another episode of The Parenting Brief. I’m your host, Jessica Stewart-Gonzalez, an Arizona working mom and chief of the Office of Children’s Health at the Arizona Department of Health Services. This show brings families tips and advice to help parents stay ahead of the game, even when your little one may be throwing you a curve ball. From safe sleep for newborns to managing a toddler that’s a picky eater, everything you need to know is right here.

[00:00:38] Thank you for joining me on this episode of The Parenting Brief. There are so many things that impact the health and development of a child that we have talked about on this show in previous episodes. Many of these topics address when to talk to your child’s healthcare provider about concerns. But without health insurance, those appointments can be expensive, especially if they are unplanned or require a referral to a specialist.

[00:01:01] Our guest today talks about how to enroll kids in the Children’s Health Insurance program and gives us details about this low cost program that provides health coverage to children with families who are unable to buy a private plan. All of that is up next.

[00:01:20] Our guest today is Mark Schafer, and he’s the program support administrator at the Arizona Healthcare Cost Containment System or AHCCCS. Thank you for coming on the show today Mark.

[00:01:31] Mark Shafer: You’re welcome. Appreciate the opportunity. Thank you.

[00:01:34] Jessica Stewart-Gonzalez: So how does access to health insurance impact the health and development of young children?

[00:01:41] Mark Shafer: Well, I can speak from experience with healthcare and kids. You know, if kids aren’t healthy and they’re not getting their checkups and getting things taken care of, that impacts into other areas of the life and impacts into the parents also.

[00:01:58] Jessica Stewart-Gonzalez: And what is the Children’s Health Insurance program and who can use it?

[00:02:03] Mark Shafer: There’s several groups within this. So you have like the Kids’ Care then there’s The Child, which is another one of the programs. So it really starts, there’s The Newborns, then there’s the AHCCCS Child Program and The Child, there’s in several different groups, and sorry if I’m getting gonna get too technical, but like The Child is for ages, you know, you have to be under 19.

[00:02:29] So we actually have several programs within AHCCCS and of course all one has to do is just, you know, apply for the program.

[00:02:38] Jessica Stewart-Gonzalez: And what type of services or healthcare services are covered through the AHCCCS program?

[00:02:45] Mark Shafer: Do you want me to go through them all cause there’s doctor visits, immunizations, prescriptions, lab, and x-rays, early and periodic screening, diagnosis and treatment services, specialist care, hospital services. There’s transportation to doctor, emergency care, podiatry services, chiropractic services. There’s pregnancy care. But that would be for general. So this is just all in general. There’s surgery, physical exams, behavioral health. There’s family planning services there, dialysis, glasses, including replacements for children under age 21.

[00:03:17] Vision exams for children under age 21. And dental screening, again, children under 21. Treatment under 21. And then for the older, like the moms or the dads, there’s emergency dental for 21 and older only and then there’s hearing exams for children under 21.

[00:03:32] Jessica Stewart-Gonzalez: If somebody goes to apply, do they need to specifically select the correct program to apply for, or do they just apply for AHCCCS and then depending on their eligibility, would identify which program that they may qualify for?

[00:03:46] Mark Shafer: We screen for all the programs. So once somebody applies, they’ll process it and they’re based on income levels and so forth. So if you say you applied for Kids Care, we’ll screen for Child, we’ll screen for all the others that could be potentially eligible.

[00:04:01] Jessica Stewart-Gonzalez: And is that the same for if they just apply for access for their family in general?

[00:04:06] Mark Shafer: That is correct, yes.

[00:04:08] Jessica Stewart-Gonzalez: So with that, when somebody does apply, it’s great to know that they don’t need to know specifically which program they’re applying for or what would be worse is having to individually apply for various programs. Cause I know that would be probably incredibly time intensive. And does the whole family have to qualify for the program?

[00:04:28] Or let’s say if an adult doesn’t qualify, can a child qualify? What does that really look like for those family dynamics?

[00:04:36] Mark Shafer: That is exactly right. You could have the families, they’re very dynamic these days, so you could have like mixed households as far as like dad with his kids, you know, and so forth.

[00:04:48] So once you apply for the entire family, we screen each and every person individually for whatever program they may be potentially eligible for. And yes, sometimes you’ll have someone who’s not eligible and the kids are, sometimes the whole family is, again, it’s based specifically on the individuals, and, you know, the income level and the way that the household groups are looked at. When somebody applies for AHCCCS, do you only need one person to, they usually are considered the primary informant and they then add, you know, the spouse and the children and so forth, and everybody would be on the same application.

[00:05:26] Jessica Stewart-Gonzalez: So in preparation for somebody to do the application online, what information or documents should they already have or have reviewed prior to going on and doing the application in order to ensure that kind of expedited process of not needing to have additional information that might be necessary?

[00:05:49] Mark Shafer: Probably the most important would be any income or wage information handy in the event you might have to, you know, to send it in, so it wouldn’t hurt to gather that. Generally once we key in like the child’s name and the social security number, the system reaches out and matches it and it shows it’s good.

[00:06:07] So rarely, if ever, do we need like a copy of a birth certificate, you know, stuff like that. So really it’s just making sure they’re careful how they enter the stuff. So I enter my name correctly. How I’m known legally type thing. And that’s pretty much it cause it kind of guides you through it on the application.

[00:06:26] So it’s gonna ask for the household members, their date of birth, their ages, all that stuff. Then it goes into the wage, you know, or any income. So it’s pretty much what most people get requested information for would be verification of income.

[00:06:41] Jessica Stewart-Gonzalez: Is there any other information about any of the access programs that children qualify for, that you would want our listeners to know about that we haven’t covered already?

[00:06:52] Mark Shafer: Well, I think what I would like for them to take from it, it’s really, really easy to apply. Your situation today may making that, that you’re not eligible. We know especially with everything everybody’s gone through, how situations can change very fast. When there’s a situation change, if income is lowered, I would highly recommend reapply again. Because you could be eligible at that time, so if you’re not eligible now, you could be later depending on the circumstances.

[00:07:29] Jessica Stewart-Gonzalez: If you’d like to learn more about accessing health insurance through an AHCCCS plan, visit the show notes for links to helpful resources. Remember to follow the show on this podcast player. That way you’ll never miss another episode. And if you found the information in today’s episode useful, please share it with the other parents or caregivers in your life.

[00:07:47] Until next time, this is Jessica. You’ve got this.