Uninsured Children

If Your Child is Uninsured

If your child is uninsured at the time when diagnosed and referred for BMT, there are a number of programs that may be able to help provide insurance coverage. Washington also offers several state-funded insurance programs for children, both citizens and non-citizens, in addition to Medicaid. At CHRMC and SCCA, all BMT families are referred to the Financial Services office, where they are assigned a to specific staff person who will help explore any and all avenues of coverage for their child, and assist with the application process. In WA, there are income, but not necessarily asset, limits for state children’s medical programs. Please note that there may be limits or restrictions on types of services covered, on specific providers or facilities participating under each plan, and there may be waiting lists for enrollment.

Uninsured children in low-income families are also eligible for coverage of charges for hospital care they receive anywhere in the state , on an inptient and outpatient basis, under  Washington’s Charity Care Law . Se the Financial Assistance topic  for more about this law.

Note: In late September 2007, Congress passed bills reauthorizing the conintuance of the State Children’s Health Insurance Program or SCHIP, but the legislation was vetoed by President Bush. At the present time, advocacy efforts are now under way nationwide to fight to preserve the program through a Congressional override action. Thus, the future of this program is still unknown. For more information please contact the Children’s Alliance here in WA, or Families USA on the national level.

Your child may be able to obtain health insurance coverage from one of the following programs:

Medicaid/Basic Health Plus
Your first step should be to check eligibly for the regular children’s Medicaid program. To qualify, your child must be under age 19, be a US citizen or permanent resident who arrived prior to August 22, 1996, and your family income must be less than 200% of the current Federal Poverty Level (FPL) which is now  $2,282/month for a family of 3 in WA. The complete FPL look-up table is updated annually. The WA Children’s Medicaid program is also called Basic Health Plus. There are no premiums or co-pays.

Children’s Health Insurance Program (CHIP)
If she meets the Medicaid eligibility criteria except that your family income is slightly higher, from 200-250% of the FPL, your child may be eligible for the Children’s Health Insurance Program (CHIP), a combined state and federal program (on the federal level, the acronym SCHIP is used, to mean State Children’s Health Insurance Program). Premiums and co-pays are charged for CHIP.

Children’s Health Program (CHP)
Children under 18 whose families earn less than 100% of the current FPL, and who are not eligible for Medicaid due to their immigration status, are eligible to enroll in the state Children’s Health Program (CHP). At times, there may be waiting lists to enroll in CHP.

Washington State Health Insurance Pool (WSHIP)
WSHIP, also known as the high-risk pool, offers coverage to uninsured WA residents who have been denied coverage due to their health status by commercial companies selling individual insurance plans, or who cannot purchase individual coverage because it is not available in the county in which they live. Children can be covered by WSHIP plans in two ways: 1) if under 19 and a parent is covered by WSHIP plan; and, 2) as an individual  on the same basis of medical need as an adult. Premiums for WSHIP enrollees under age 25 range from about $83-$ $418 per month, depending on age, plan and deductibles.

If Your Uninsured Child is Not a US Citizen

If your child is not a citizen, s/he may be eligible for programs to provide coverage for certain medical expenses. All noncitizen minors (up to age 18 or 21, depending on program) including those here on student or visitor visas, as well as those with permanent residency and with undocumented status, may be eligible if their family income meets program requirements.

Alien Emergency Medical Program (AEMP)

AEMP covers the costs of emergency medical care for all those who would be eligible for Medicaid except for the citizenship requirement. Note that BMT is not considered emergency care, but illness-related needs might be an emergency. There are income and asset requirements for AEMP, and an application is required. The DSHS page on AEMP has program details.

Special cases

There are also certain groups of immigrant or refugee children in vulnerable situations who may qualify for special status categories under immigration laws, and thus possibly can become eligible for Medicaid. However, it is necessary to get expert legal assistance to evaluate each  case in order for such a determination to be made. Therefore, it is essential that a timely referral to an immigration legal services advocacy agency be made for each child and/or family, whenever questions about immigration status arise. The legal services agencies listed below serve low-income immigrant and refugees statewide, and provide interpreter services. Call to request an intake appointment.

Northwest Justice Project (NWJP)
Refugee and Immigrant Advocacy Project
206 464-1519 or toll-free 1-888-201-1012

Northwest Immigrant Rights Project (NWIRP)
Immigrant Child Advocacy Project
206-587-4009 or toll-free 1-800-445-5771

Additional Resources

Within Reach
Health insurance website
Toll-free 1-800-322-2588
Portal for information on all services promoting health and well-being of WA children and families. Offers phone hotline and down-loadable applications for medical care programs for low-income children. Makes referrals to developmental, childcare, education, nutrition services for children, and programs for parents.

Healthy Kids Now

Toll-free line: 1-877-Kids-Now (1-877-543-7669)
State of WA portal to all health insurance programs for low-income children.

Basic Health Program
Website for BHP for both children and adults

State Health Insurance Benefits Advisors (SHIBA)
Toll-free line: 1-800-562-6900
Helpline with SHIBA-trained volunteers offering consumer information and assistance on health insurance; healthcare and medicines programs (primary focus on adult programs)

Washington State Health Insurance Pool (WSHIP)
Toll-free line: 1-800-877-5187
WA high risk insurance pool program for both children and adults.

Eligibility Tools

ParentHelp123.org
Online screening tools to help WA parents learn if they are elgilbe for health insurance and food assistance programs. Site includes program-specific application forms.

WA Income Guidelines for Children’s Medicaid and CHIP

WA Income Guidelines for the Children’s Health Program

2007 Federal Poverty Level  (FPL) look-up table