Here are 4 Free or Low-Cost Ways to Get Health Care for Your Child.
It might make sense to get your child covered separately from you and your spouse.
Read on....
Note: This information is applicable to California residents. Similar or better options may be available in other states. You should research all the options wherever you are located.
1. Medi-Cal for Families:
Medi-Cal for Families is for those families with little to none, or very low income. Examples would be those whose unemployment benefits have expired. Or those who are self-employed, or run a small business and have minimal or even negative income(the cash-burn, no-revenue mode of most start-ups).
Income Limits: The income limits are a maximum of $750 a month for a family of 2, $934 per month for a family of 3, and $1,100 per month for a family of 4.
Who can get coverage: Children living in California up to their 21st birthday.
Coverage: Medical, Dental & Vision
Coverage Cost: Free.
Treatment Cost: Free.
Plans and Providers: Medi-Cal will send you a directory of Providers in the mail once they approve your application.
2. Healthy Families:
Healthy Families is for those who are above the income limits to qualify for Medi-Cal.
Income Limits: The income limits are different for different ages and different family sizes - maximum income is $3,036 per month for a family of 2 with children between 6 and 18 years of age. And maximum income is $4,594 per month for a family of 4 with children between 6 and 18 years of age.
Who can get covered?: Children living in California who are under 19 years of age, who have not been covered by group health insurance in the past 3 months, who meet the immigration guidelines of Healthy Families, and who do not qualify for Medi-Cal.
Also pregnant women who have not been covered by group health insurance in the past 3 months, who meet the immigration criteria and who do not qualify for Medi-Cal.
Coverage: Medical, Dental & Vision
Coverage Cost: Depending on which income category you fall in (there are 3 income categories), your premium will be $4 per child per month, $8 per child per month or $24 per child per month.
Treatment Cost: Free, or $5 per service. Maximum out-of-pocket limit - $250 per family per year.
Plans and Providers: There are different plans and providers in each county. In San Francisco County, there's Blue Shield, Healthnet, San Francisco Health Plan and Kaiser Permanente.
3. Kaiser Child Health Plan:
Kaiser Child Health Plan is for those who do not income qualify for either Medi-Cal or Healthy Families.
Income Limits: The income limits are different for different family sizes. To give you an idea, a family of four can have a maximum income before taxes of $66,150 to qualify.
Who can get covered?: Children living in California who are under 19 years of age, do not have any employer-based insurance, and do not qualify for Healthy Families or Medi-Cal.
Coverage: Medical, Dental & Vision
Coverage Cost: Minimum of $8 per child per month, maximum of $15 per child per month, depending on gross annual income before taxes.
Treatment Cost: $5 for most services. Medicines - $5 for generic, $20 for brand name (100 day supply). Maximum out-of-pocket limit - $250-$500 per family per year.
4. Kaiser HSA High-Deductible Health Plan:
If you do not qualify for Medi-Cal, Healthy Families or the Kaiser Child Health Plan...
Then you will need to choose between your Cobra coverage.
Or an individual health plan from one of the HMOs or private insurers.
The Kaiser Permanente HSA approved High-Deductible Health Plan is one option.
It is one of 3 kinds of plans offered by HMOs and private insurers. The 3 kinds of plans available in the healthcare market are copay plans, high deductible plans and HSA approved high-deductible plans.
Since the high-deductible plans have the lowest premiums, I have chosen to feature one of those.
The plan featured has the words HSA in its name.
This indicates you can open an HSA tax-sheltered account along with the plan.
An HSA account is a tax-sheltered account, in which you can save money for your health expenses.
You incur no tax for the interest, dividends or appreciation of the money in the account, if you withdraw the money for approved health expenses.
So HSA plans offer 2 tax benefits - tax-deductible premiums and the option to open a tax-sheltered HSA account.
However, with all the tax benefits, you may find the cheapest high-deductible health plan for your child rather pricey.
For instance, the most economical HSA plan offered by Kaiser is the 40/4000NM.
It comes with $40 copays, a deductible of $4000 per year (ouch), and a maternity exclusion.
The premium for this plan is $95 per month for a teen, and you will need to pay out of pocket for all visits, tests, treatments and medicines until your deductible of $4000 is met.
However, since going uncovered is not an option - it could devastate you financially, you should call Kaiser at 1-800-245-318 and explore the plan. It may turn out to be your most cost-effective option.
It is very important you select any plan with your eyes wide open, since there's a lot to understand and digest -- the deductible, the copays, the coinsurance, the exclusions, and more.
Also, Blue Shield of California, HealthNet and Aetna also offer individual health plans. You don't have to go with Kaiser.
E-surance can help you compare between the plans of different providers and select the right one. You can spare yourself the hassle of researching plans by yourself using their services.
E-surance says it can get you an approval in 11 minutes.
So there you have it - these are the 4 ways to get Health Care for Your Child in sunny (right now rather rainy, actually) California.
Hope you find one a plan for your child that's right for you.
Don't delay. Both your child's health and your money are on the line.
Wishing you and your family a Healthy and Happy 2011.
No comments:
Post a Comment