Governor revamps KidCare enrollment

CHICAGO - Governor Blagojevich directed the Illinois Department of Public Aid (IDPA) to streamline its enrollment application process for its acclaimed KidCare health insurance program. The move guarantees that thousands of Illinois children will no longer have to wait over a month to be eligible for healthcare services.

                       

"No child in Illinois should wait for vital medical care because of bureaucratic red tape," said Gov. Blagojevich, who helped create the federal program that funds KidCare as a member of Congress in 1997. "We have already expanded eligibility for the program and now we are going to improve KidCare by making sure kids get access to care when they need it."

 

Gov. Blagojevich has made health care for children, families and seniors a priority. Illinois was one of only three states in the nation that significantly added more people to health coverage in the current year without cutting rates to providers, according to a recent national study by the Kaiser Commission on Medicaid and the Uninsured.

 

Starting in January, IDPA will reverse its current income verification policy from a month's worth of pay stubs to one.  Previously, applicants were required to submit at least four pay stubs to verify their income.

 

In addition, the Department will seek federal approval for Presumptive Eligibility, which provides immediate coverage for children under KidCare once their parents file an application stating they meet the program's income threshold. Illinois currently provides presumptive eligibility to pregnant women. The U.S. General Accounting Office has found that it is an effective outreach tool.

 

Taken together, these policy improvements will make it easier for families to get access to healthcare faster and to eliminate a gap in coverage that is often over a month between the time

the application is received and the day a final decision on the application is made. The rapid enrollment assured by presumptive eligibility gives medical providers an added incentive to help families apply for KidCare. It gives providers a higher degree of confidence that the application will be approved and that care delivered on the day of the application will be covered. For instance, if a doctor's office assists a family which appears to be eligible under the guidelines in preparing a KidCare application and faxes the application to the Department, any health care delivered that day will most likely be paid for by KidCare.

 

IPDA Director Barry S. Maram said the policy switch is also a key element of the department's effort to reach out and identify children and families who qualify for KidCare and FamilyCare under the expansion signed into law by the Governor in July. The higher income threshold made an additional 20,000 children and 65,000 parents eligible for the program this year.

 

This year's expansion raised the income threshold for both KidCare and FamilyCare, making 20,000 more children and 65,000 parents eligible for comprehensive health coverage this year. Over the next three years, 300,000 adults will be eligible for coverage under the FamilyCare expansion.

 

The announcement about the application changes comes as KidCare outreach workers are fanning out across the state this month to promote the expansion through meetings with members of its network of 1,400 KidCare Application Agents and 500 providers who assist pregnant women in getting presumptive eligibility. Forums to explain the new guidelines and income thresholds are being held in Springfield, Belleville, Galesburg, Urbana, Chicago, St. Charles, Chicago Heights, Rockford and Carterville. .

 

"We have a terrific program that provides crucial health coverage for thousands of children and families," said Maram. "We want to make every effort to guarantee that all the children eligible for KidCare get the health care they are entitled to."

 

The income threshold for KidCare was raised as of July 1 from 185 percent of the Federal Poverty Level (FPL) to 200 percent. That means, for example, that children in a family of four are eligible for coverage if income does not exceed $36,804, after certain limited deductions such as child care and employment expenses. With deductions, families with income of over $40,000 may now qualify for this health coverage. .

 

For adults, the income cap was raised as of July 1 from 49 percent to 90 percent of the Federal Poverty Level. That means parents are eligible if the income for a family of four is not more than $16,560, or more than $20,000 with deductions. The cap for parents is being raised over the next three years to 185 percent of the poverty level.

 

Covered services under KidCare/FamilyCare include doctor and nursing care, shots and well-child care, hospital and clinic care, laboratory tests and x-rays, prescription drugs, medical equipment and supplies, medical transportation, dental care, eye care, psychiatric care, podiatry, chiropractic care, physical therapy, mental health and substance abuse services. Pregnant women also receive prenatal care and other medical services.

 

For more information, visit kidcareillinois.com or call 1-866-4-OUR-KIDS (1-866-468-7543).