Avery Slyker, Ph.D.Program Manager

Florida Covering Kids & FamiliesLawton and Rhea Chiles Center for Healthy Mothers and Babies

University of South Florida

Updated 2015-03-08

Objectives

• Introduce and define CHIP and Medicaid in Florida.

• Inform participants about the issues of the uninsured and it’s impact on community health and well-being.

• Educate participants about the Florida KidCare program, our state’s CHIP and Medicaid program, including who is eligible and it’s benefits.

• Explain how community partners can improve enrollment and retention by conducting collaborative outreach activities.

Updated 2015-03-08

Definitions• Medicaid

– Medicaid provides health coverage for low-income children. The federal government sets minimum guidelines for Medicaid eligibility, but states can choose to expand coverage beyond the minimum threshold.

• Children’s Health Insurance Program (CHIP)– Like Medicaid, CHIP is administered by the states, but is jointly

funded by the federal government and states. The Federal matching rate for state CHIP programs is typically about 15 percentage points higher than the Medicaid matching rate for that state (i.e. a State with a 50% Medicaid FMAP has an “enhanced” CHIP matching rate of 65%). Every state administers its own CHIP program with broad guidance from CMS.

Updated 2015-03-08

Florida Covering Kids & Families

• Florida Covering Kids & Families (FL-CKF) works collaboratively with Florida businesses and individuals to advocate and conduct outreach for Florida KidCare.

• The initiative aims to foster and facilitate innovative and collaborative approaches for enrolling and retaining eligible children in Florida KidCare.

• FL-CKF Statewide Coalition members have unique vantage points and access to agency and community resources which foster a productive environment where collaboration results in better health for Florida's children.

Updated 2015-03-08

8.5% of Uninsured Children Live In Florida

Percent of Uninsured Children

2013 State Ranking in Percent of Uninsured Children

Number of Uninsured Children

2013 State Ranking in Number of

Uninsured Children

Florida 11.1 47 445,035 49

National 7.1 - 5,234,332 -

Source: “Children’s Coverage at A Crossroads: Progress Slows”, Georgetown Center for Children and Families, November 2014.

Uninsured Children In Florida

Updated 2015-03-08

Florida Ranks 47th for Uninsured Kids RateFlorida 11.1%

Alaska 11.6%

Arizona 11.9%

Texas 12.6%

Nevada 14.9%

Source: ibid.

Uninsured Children In Florida

Updated 2015-03-08

Florida Has Been Improving Slowly

*Florida is one of twelve states that experienced a statistically significant decrease in percentage point change

2011-2013 Percent Point Change

Rank 2011-2013 Percent Point Change

United States -0.4 -

*Florida -0.8 12

Source: ibid.

Uninsured Children In Florida

Updated 2015-03-08

5.5

5.77.6

4.3 9.6

6.76.35.7

11.1

Florida has the highest uninsured rate for kids in the South

Source: “Children’s Health Coverage in Florida: Fewer Uninsured But Challenges Lie Ahead”, Florida Philanthropic Network, November 2014.

Uninsured Children In Florida

Updated 2015-03-08

Health Implications for Uninsured

30% less likely to receive medical attention for

injuriesUninsured newborns have lower

birth weights

Less likely to have regular medical doctor

No immunizations or medical treatment for

common childhood illnesses

Uninsured newborns higher rates of premature deaths

Delay health care until in crisis

Forgo prescription medicines

Updated 2015-03-08

Costs to Communities

• When their children are ill, employee absences cost business as much as $12 billion annually.

• 350,000 children in the US are too sick to attend school or childcare every day.

• Mothers are absent from their jobs from 5 to 29 days per year caring for ill children.

Updated 2015-03-08

Benefits to Communities

• Children with a regular source of health care are more likely to get well-child checkups and have fewer preventable diseases.

• Parents of children who have fewer sick days home from school are less likely to miss work.

• Quality of life is improved for children in the community.

Updated 2015-03-08

Florida KidCare Eligibility

• Are under age 19• Are a Florida resident• Do not have health insurance

(does not apply to Medicaid)• Are U.S. citizens or qualified non-

citizens• Are not in a public institution• Meet income eligibility—if income

exceeds 200% FPL, families may qualify for Florida KidCare Full-Pay

Updated 2015-03-08

Florida KidCare Benefits: Check Ups To Transplants

• Doctor’s Visits• Check-Ups &

Shots• Hospital, Surgery

& Emergency Services

• Vision/Hearing• Mental &

Behavioral Health

• Prescriptions• Dental

Updated 2015-03-08

Cost• Most families pay only $15

or $20 for coverage, depending on family size and income.– Full-Pay option is

available for families with a higher income

• There is no deductible • There are minimal co-pays

Florida Healthy Kids

•Ages 5-18 are $153/per month/per child with dental•$140/per month/per child without dental

MediKids

•$157 per month per child

Full Pay Option

Updated 2015-03-08

Florida KidCareFlorida Healthy Kids

Children’s Medicaid MediKids

Children’s Medical Services Network

FloridaKidCare

Updated 2015-03-08

Children’s MedicaidFor children from birth through age 18

Eligibility determined by the Department of Children and FamiliesEligibility is based on child’s age, household size, income and citizenship

Families pay nothing for coverage

Updated 2015-03-08

MediKidsFor children ages 1 through 4, not eligible for Medicaid

Administered by the Agency for Health Care Administration (AHCA)

Services delivered through managed care plans (HMO and PSN).

Most families pay $15 or $20 per monthFull-pay option available:– $157 per child per month

Updated 2015-03-08

Florida Healthy KidsFor children ages 5 through 18, not eligible for

MedicaidAdministered by the Florida Healthy Kids

CorporationServices delivered by managed care plansMost families pay $15 or $20 per monthFull-pay Option:

• $153 per child per month w/dental • $140 per child per month w/o dental

Updated 2015-03-08

Children’s Medical Services NetworkFor children from birth through age 18 Clinical determinations by the Florida Department of

HealthFor children with special health care needs, including

behavioral health network (BNet)

Special network of physicians and providers

Updated 2015-03-08

Application Tips

• It’s easier to apply online! Apply at www.floridakidcare.org

• Make sure all documents are legible copies and the account, date of birth, and child’s SSN is clearly indicated on each document.

• Application in English, Spanish and Creole.

Updated 2015-03-08

Eligibility Processing

• All applications are:o Acknowledged by letter once received and

if needed, a request for missing information is sent

o Screened for Children’s Medicaid eligibility. If eligible, the child must enroll in Children’s Medicaid• If referred to DCF, a referral letter for the family is

mailed

o If an applicant indicates their child has special health care needs they are screened for CMSN

Updated 2015-03-08

Monthly Premium Payments

Internet & Telephone

• 24 hours a day, 7 days a week• Visa, MasterCard and Discover accepted• Direct from checking or savings account• Fee may be charged

Mail

• Mail a check or money order with payment coupon to Florida KidCare• Write your family account number on check or money order

Other Payment Opitions

• Opt-in to pay monthly premiums by text message• Automated payment• Pay cash at a “Fidelity Express” location

• $2 service fee applies and can only process cash payments Visit https://www.healthykids.org/pay/automated for all payment options.

Updated 2015-03-08

Renewal Process

For CHIP (MediKids, Florida Healthy Kids, CMSN):• Enrollees must renew coverage every 12 months from date of

enrollment

For Medicaid:• Renewal for coverage every 12 months from date of enrollment,

however,

• Enrollees ages 5 to 19 must recertify coverage every 6 months from date of enrollment if family receives additional benefits

Online account renewal and renewal forms are also available online at www.floridakidcare.org or http://www.myflorida.com/accessflorida/

Updated 2015-03-08

No Wrong Door

Updated 2015-03-08

Why is it important?• Florida still has a long way to go until all children have access

to affordable health care.• Improving the knowledge of the public can make a

tremendous impact on community health.• Navigating the system can sometimes be frustrating and it is

important to link families to 1-on-1 application or technical assistance.

• Community partnerships allow individuals to find local, knowledgeable experts on Florida KidCare.

• Interpersonal relationships make a big difference when it comes to improving program perceptions and understanding.

Updated 2015-03-08

Community Outreach Partnerships• Introduce organizations to a valuable health

coverage program to increase awareness.• Reach large numbers of eligible, working

families.• Establish new communication channels and

resources to engage the community.• Partnerships impact employees, customers

and consumers who may find the program useful.

Updated 2015-03-08

Strategic Outreach InitiativesIndividuals and Families

Community-Based Organizations

Businesses

Health Care Providers

Military and Veteran Support Services

Updated 2015-03-08

Key Partners• Identify organizations and individuals that share common

goals with your organization.

• Provide information and resources as requested and make partnership efforts a win-win.

• Staff any community or employee health fairs or outreach events and explore ways to promote the program within their organization.

• Always follow up and keep a tickler file for those you have worked with in the past.

Updated 2015-03-08

Florida Covering Kids & Families

Jodi Ray, M.A., Principal Investigator, Program Director (813) 974-3143 jray@health.usf.edu

Avery Slyker, Ph.D. Program Manager (813) 974-8272 arosnick@health.usf.edu

Informational Web Siteswww.floridakidcare.org

www.healthykids.org http://floridacoveringkidsandfamilies.health.usf.edu

www.insurekidsnow.org