Call 1-877 KIDS NOW (1-877-543-7669) or go to the Web site for your State's Program. When you call our free and confidential hotline, you will be directly connected to your state's program that provides either free or low-cost health insurance for children. The states have different eligibility rules, but in most states, uninsured children 18 years old and younger whose families earn up to $34,100 a year (for a family of four) are eligible.
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How can I get more information on my state's program?
Simply click on the link to the Web site for your State's Program or call the Insure Kids Now! hotline at 1-877-KIDS-NOW (1-877-543-7669). The call is free and confidential. When you call, you will speak with someone from the children's health insurance program in your state. They can send you an application and help you apply.
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Is there a limit on the amount of time my child can remain enrolled?
Your child can stay on the program as long as he or she qualifies. Although there is no limit on the amount of time your child can remain on the program, you will need to renew their coverage periodically, generally every 6 to 12 months. As long as your children continue to meet the eligibility criteria established by your state, they can remain on the program.
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What services does the insurance cover?
For little or no cost, this insurance pays for doctor visits, prescription medicines, hospitalizations, and much more. Most states also cover the cost of dental care, eye care, and medical equipment.
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Is this program new?
In 1997 Congress passed legislation that allows states to provide health insurance to more children in working families. These programs build on the Medicaid program that started covering children and adults in the mid-1960's.
I need health insurance for my children. What are my options?
Saturday, May 24, 2008
Posted by Average Joe at 12:38 AM 0 comments
Children's Mental Health — Insurance and Payment Issues
It's important that you know exactly how much your insurance company will pay. Your insurance package may provide limited coverage for mental health services. It may help to ask your insurance company the following questions:
* Does my pediatrician need to formally recommend that my child see a mental health professional before the cost of the visit is covered? Or do I need approval through a separate process specifically for mental health services?
* Do I have to choose a doctor or counselor from an approved list? Does the list include professionals with expertise in children and their families?
* Are certain disorders excluded from coverage?
* Is there a lifetime or annual limit for mental health coverage? If so, what is it?
* Exactly how much of the cost of mental health services will I need to pay?
Your pediatrician may direct you to other resources if you don't have health insurance, if your health care plan doesn't cover mental health care, or if your health care plan doesn't provide enough mental health coverage to meet your family's needs.
In some communities, mental health centers or family service agencies charge based on what you are able to pay. Medicaid or the State Children's Health Insurance Program (SCHIP) — publicly funded programs to cover the medical costs of low-income children — also cover some mental health costs. In some states and for some diagnoses, these or other funds may be available, even if you have private insurance, for mental health services not covered by your health insurance.
If you have trouble obtaining or filling out a Medicaid or SCHIP application, ask the pediatrician's office for help. For more information about Medicaid or SCHIP contact the Centers for Medicare & Medicaid Services at 1-877-267-2323 or www.cms.hhs.gov
Self-help organizations may also offer counseling and support to children and their families. These organizations operate drop-in centers and sponsor gatherings for group discussions on specific topics, such as substance abuse or attention and learning problems. Your child's school may have guidance counselors and other professionals with training in behavioral health assessment and treatment. Clergy can also provide help. It's important to talk about each of these options with your pediatrician.
When speaking with or writing to an insurance company, keep these five points in mind:
* Don't be afraid to ask questions.
* Keep good communication records, including with whom you spoke and on what day and time.
* Be polite.
* Be patient.
* Be persistent.
Privacy Issues
The law protects your privacy related to mental health but allows your doctor to share information with other professionals involved in your child's and family's treatment.
In some cases, you will need to sign special forms authorizing the release of information. This may include medical, family, school and social history records. You can decide whether to give out this information.
At a certain age (which varies by state), your child may legally consent to or refuse care. Your pediatrician can help explain these laws and how they affect your child and your family.
It's common for parents and families to feel as if their child's problems are their fault. Many people are also afraid or embarrassed about a child's need for mental health treatment. While these feelings are normal, it's important that you not blame yourself for your child's problems. Your pediatrician, along with one or more mental health professionals, can help you better understand your child's behavior. They can guide you and other members of your family to help in the healing process.
If you are separated or divorced from your child's other parent, it's important to establish a plan for including the other parent in your child's assessment and treatment. Your pediatrician will help you decide whether scheduling visits together or separately, sharing reports, or making phone calls can best do this.
It's very helpful for you to continue to talk with your pediatrician and with the doctor or mental health professional who is working with your child.
Read More..
* Does my pediatrician need to formally recommend that my child see a mental health professional before the cost of the visit is covered? Or do I need approval through a separate process specifically for mental health services?
* Do I have to choose a doctor or counselor from an approved list? Does the list include professionals with expertise in children and their families?
* Are certain disorders excluded from coverage?
* Is there a lifetime or annual limit for mental health coverage? If so, what is it?
* Exactly how much of the cost of mental health services will I need to pay?
Your pediatrician may direct you to other resources if you don't have health insurance, if your health care plan doesn't cover mental health care, or if your health care plan doesn't provide enough mental health coverage to meet your family's needs.
In some communities, mental health centers or family service agencies charge based on what you are able to pay. Medicaid or the State Children's Health Insurance Program (SCHIP) — publicly funded programs to cover the medical costs of low-income children — also cover some mental health costs. In some states and for some diagnoses, these or other funds may be available, even if you have private insurance, for mental health services not covered by your health insurance.
If you have trouble obtaining or filling out a Medicaid or SCHIP application, ask the pediatrician's office for help. For more information about Medicaid or SCHIP contact the Centers for Medicare & Medicaid Services at 1-877-267-2323 or www.cms.hhs.gov
Self-help organizations may also offer counseling and support to children and their families. These organizations operate drop-in centers and sponsor gatherings for group discussions on specific topics, such as substance abuse or attention and learning problems. Your child's school may have guidance counselors and other professionals with training in behavioral health assessment and treatment. Clergy can also provide help. It's important to talk about each of these options with your pediatrician.
When speaking with or writing to an insurance company, keep these five points in mind:
* Don't be afraid to ask questions.
* Keep good communication records, including with whom you spoke and on what day and time.
* Be polite.
* Be patient.
* Be persistent.
Privacy Issues
The law protects your privacy related to mental health but allows your doctor to share information with other professionals involved in your child's and family's treatment.
In some cases, you will need to sign special forms authorizing the release of information. This may include medical, family, school and social history records. You can decide whether to give out this information.
At a certain age (which varies by state), your child may legally consent to or refuse care. Your pediatrician can help explain these laws and how they affect your child and your family.
It's common for parents and families to feel as if their child's problems are their fault. Many people are also afraid or embarrassed about a child's need for mental health treatment. While these feelings are normal, it's important that you not blame yourself for your child's problems. Your pediatrician, along with one or more mental health professionals, can help you better understand your child's behavior. They can guide you and other members of your family to help in the healing process.
If you are separated or divorced from your child's other parent, it's important to establish a plan for including the other parent in your child's assessment and treatment. Your pediatrician will help you decide whether scheduling visits together or separately, sharing reports, or making phone calls can best do this.
It's very helpful for you to continue to talk with your pediatrician and with the doctor or mental health professional who is working with your child.
Posted by Average Joe at 12:37 AM 0 comments
How to File a Claim for Your Benefits
The Employee Retirement Income Security Act of 1974 (ERISA) protects the interests of participants and their beneficiaries who depend on benefits from private employee benefit plans. ERISA sets standards for administering these plans, including a requirement that financial and other information be disclosed to plan participants and beneficiaries and requirements for the processing of claims for benefits under the plans.
Although some employee benefit plans are not covered by the Act (such as church or government plans, etc.), if you are one of the millions of participants and beneficiaries in employee benefit plans that fall under the Act's protection, you have certain rights if your claim for benefits is denied.
Your plan must give you the reason for denial in writing and in a manner you can understand. It also must give you a reasonable opportunity for a fair and full review of the decision.
This folder outlines the steps you may take to file a claim and what to do if you are denied benefits.
Posted by Average Joe at 12:36 AM 0 comments
Health Insurance
Health insurance helps protect you from high medical care costs. Many people in the United States get a health insurance policy through their employers. In most cases, the employer helps pay for that insurance. Insurance through employers is often with a managed care plan. These plans contract with health care providers and medical facilities to provide care for members at reduced costs.
You can also purchase health insurance on your own. It usually costs you more than employer-based insurance. People who meet certain requirements can qualify for government health insurance, such as Medicare and Medicaid. If you do not have health insurance, you must pay your medical bills directly or rely on health care providers or organizations that donate care.
Start Here
* Health Insurance: Understanding What It Covers(American Academy of Family Physicians)
Also available in Spanish
* Health Insurance: Understanding Your Health Plan's Rules(American Academy of Family Physicians)
Also available in Spanish
* Top 10 Ways to Make Your Health Benefits Work for You(Dept. of Labor)
Posted by Average Joe at 12:34 AM 0 comments
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