Covering Kids Aids Insurance Education Funds For Free Or Low-cost Coverage For Youths Up To Age 19 Sit Unused. This Program Helps Make Families Aware Of Options.

Posted: June 06, 1999

Uninsured families may think that medical coverage is beyond their means, but they could be eligible for free or low-cost health insurance.

As part of a a statewide effort to enroll the estimated 283,000 uninsured youths in Pennsylvania, a national program called Covering Kids, got under way last week in Southeastern Pennsylvania.

Its purpose is to sign up the uninsured in government-funded health-insurance programs, such as the Children's Health Insurance Program in Pennsylvania.

The program, which is administered by the Pennsylvania Insurance Department, provides free and low-cost health insurance for youths up to 19 years old in eligible uninsured families. It is funded with federal dollars that are matched by the state.

An uninsured family of four with an income of $33,400, for example, would qualify for free insurance. The low-cost program is available to those earning between 200 percent and 235 percent of the federal poverty level. Children up to age 19 receive medical services, such as dental and vision, immunizations, prescription drugs and mental-health benefits.

"One of the groups that is important to reach are the families leaving welfare for work who may not be aware of health benefits available for them," said Pat Redmond, health director of the Philadelphia Citizens for Children and Youth, which is coordinating outreach and enrollment efforts in Southeastern Pennsylvania.

The Covering Kids initiative is funded by the Robert Wood Johnson Foundation, the nation's largest health-care philanthropy. It has allocated $17 million to 20 states for the effort. Pennsylvania's share is $1 million throughout three years and will be doled out to four pilot sites of which Southeastern Pennsylvania is one.

Studies have shown that children without health insurance are less likely to have a regular source of care, are less likely to be immunized, and are more likely to receive care in a hospital emergency room.

The success of the Covering Kids project, Redmond said, depends on the creation of a single, simple application.

"Current procedures are too complex, but the state has announced its intention to significantly simplify the process," Redmond said.

"The reason for the Robert Wood Johnson grant is that states are not spending their CHIP dollars," said Ann Bacharach, Covering Kids project director for the Pennsylvania Partnerships for Children, the group administering the program statewide. "There are many reasons why that is happening. . . One is that there is not a whole lot of knowledge out there. The primary effort of Covering Kids is to make outreach pay off in terms of enrollment."

"This grant is designed to figure out strategies that make the programs easier to enroll in," Bacharach added.

She said $25,000 a year would be split among the 10 social-service agencies and health clinics in the southeastern region. The groups will receive $25 for every uninsured person or family enrolled either in CHIP or medical assistance.

One of those agencies is the Maternal and Child Health Consortium of Chester County.

Pamela Bryer, executive director of the consortium, said her group's initiative would be conducted by five community-based providers throughout the county selected by the consortium.

"We estimate that 4,000 children in Chester County are uninsured," said Bryer, who hopes to enroll 200 children this year.

But screening people for eligibility and completing enrollment forms is a complex process both for families and outreach workers, said Peggy Dator, executive director and social worker at the Free Clinic of Doylestown and Warminster.

The clinic, which is among the 10 agencies, provides free medical care and social services to low-income and uninsured people. It enrolled about 20 people in CHIP last year.

Dator said that in most of the uninsured families, a family member had a job but worked for people who either did not offer health insurance or offered insurance for only the employee.

Dator said she planned to meet with school nurses who can assist in referrals and hoped to enroll 60 families this year.

"We have families with no awareness that free insurance programs exist, so they come through our doors because there is an immediate medical need," she said.

"Many go without insurance and resort to the hospital emergency room for primary preventive care . . . and they tend to shy away from free programs," she said.

JoAnne Fischer, executive director of Maternity Care Coalition, said the key was educating people about available programs.

The coalition, also selected to participate in the enrollment effort in the region, has 11 outreach sites in Montgomery, Philadelphia and Delaware Counties and its workers travel throughout those areas in a van equipped to offer prenatal care and outreach services to infants.

Enrollment, Fischer said, is complicated and the $25 stipend offered through the program does not pay for the strain on staff who will screen and sign people up.

"We hope that eventually the state will pay for the manpower needed for this kind of outreach, which can be very effective," she said.

For more information about CHIP, call 1-800-986-KIDS.

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