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Help for Families without Health Insurance

Help for Families without Health Insurance

By John Collett

In New York State alone, there are 2.6 million uninsured children and adults, which is 13.5 percent of the state’s population based on 2006 census data.

People who have no health insurance are afraid to seek medical care because of the cost. They typically delay seeing their doctors for as long as possible and minor problems develop into major illnesses. The results can be devastating both in terms of human suffering and the financial burden on an overtaxed health-care delivery system.

In response to this serious need, New York State sponsors two programs for uninsured residents that enable families and children to acquire health-care coverage at little or no cost. If you or someone you know does not have health insurance because they cannot afford to pay for it or because their employer does not provide it, please take a few minutes to read this column.

Family Health Plus

This program is available to single adults, couples without children, and parents with limited income who are between the ages of 19-64. To be eligible, you must be a resident of New York State and a United States citizen, or you must fall under one of many immigration categories. If you have individual or work-related health insurance, you are not eligible to enroll for Family Health Plus.

The amount of family income you have and the size of your family determine your eligibility for Family Health Plus. Under the program guidelines, if yours is a family of three earning up to 150 percent of the federal poverty guideline (which is $26,400 as of 2008), you would qualify for Family Health Plus. This is a program that helps close the gap between people who make too much income to qualify for Medicaid but who still cannot afford health insurance on their own.

The benefits of Family Health Plus are the following: 1) You pay nothing to enroll in the program and there are no deductibles once you enroll; there may be a co-payment or co-insurance when you visit the doctor. 2) The plan provides comprehensive coverage for doctor visits, inpatient and outpatient hospital services, prescription drugs, psychiatric services, chemical dependency programs, hospice care, and dental care.

Child Health Plus

This is a health insurance program for children only (through age 18) and eligibility is based on family income. There may be no costs to participating in the program, or there may be a sliding fee scale for premiums, depending on income. The covered benefits are the same as those listed above for Family Health Plus. Child Health Plus is a good and comprehensive program.

How to enroll in Family Health Plus and Child Health Plus

There are enrollment facilitators who will walk you through the process. In Tompkins County, the facilitators are at Mothers and Babies of SCNY, Tompkins County Department of Social Services, and at Cayuga Medical Center by calling (607) 252-3312. In Cortland County, you can contact the Department of Health, Cortland County Department of Social Services, and Fidelis/NYS Catholic Health Plan. You can also call toll free in New York State for more information on Family Health Plus at 1-877-9FH-PLUS or go on to their Web site at www.health.state.ny.us/nysdoh/fhplus To get more information about Child Health Plus, just call 1-800-698-4KID or go to the Web site at www.health.state.ny.us/nysdoh/chplus

A local perspective

Cayuga Medical Center’s mission is to provide care to anyone who needs our help regardless of their ability to pay. In 2007, our medical center provided nearly $3.8 million of uncompensated care, and that figure increases every year.

We are deeply concerned about the health of area residents and want to provide care as early as possible when diseases are most responsive to curative therapy. We are also committed to developing new programs and services to better meet local health care needs. As the cost of uncompensated care rises, our ability to invest in our physical plant and new technology is put at risk. Increased local enrollment in these two low-income insurance plans—which are funded with New York State tax dollars—would help to ensure the medical center’s viability into the future.

John Collett is an assistant vice president and the controller at Cayuga Medical Center. He also serves as president of the Hospicare and Palliative Care Services Board of Directors.

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