By Jessica Reynolds Staff Writer
The Daily Star
---- — New York’s Child Health Plus program is misunderstood, according to several local parents who utilize it.
Sarah Bueck, of Oneonta, said without Child Health Plus, she would be paying hundreds of dollars a month for health insurance for her 6-year-old son and 2-year-old daughter. Bueck’s children are just two of more than 1,143 Otsego County children enrolled in the program.
Despite the many people who use Child Health Plus, a common misconception remains that the program is only for people with low income even though, Bueck said, Child Health Plus is a “great” resource that anyone can make use of.
The misconception likely comes from the fact that families with incomes less than 1.6 times the poverty level, which is $600 per week for a three-person family and $724 per week for a four-person family, are eligible for free coverage, with no monthly premium, according to the program’s website. But families with higher incomes are also eligible for health insurance that is, although not free, still very affordable, the website said.
Child Health Plus was established in 1990 and is the largest state-subsidized health insurance program in the nation, according to its website. The program provides insurance for children under the age of 19 who are not eligible for Medicaid and who are not insured under a parents’ health insurance plan. Almost all children are eligible for the program, the website said, and children must be residents of New York. Cost of coverage through the state-subsidized health insurance program is based on a family’s gross income and size of the family.
According to the Child Health Plus website, families with higher incomes pay a monthly premium of $9, $15, $30, $45, or $65 per child. After paying the premium, families do not have any co-payments for services they receive through a participating provider.
Services that are normally covered include well-child care, physical exams, immunizations, x-rays and lab tests, outpatient surgery, emergency care, prescription and non-prescription drugs, inpatient hospital care, short-term therapeutic outpatient services such as chemotherapy, dental care, vision care, speech and hearing and Hospice, according to the website.
Bueck, a bank teller in Oneonta, said her children have been enrolled in Child Health Plus since they were each one-year-old. Jack, 6, and Alexa, 2, are covered through Excellus, a health insurance company that is part of the Blue Cross Blue Shield Association. In Otsego County, Excellus BCBS is the top provider for people enrolled in Child Health Plus, followed by Fidelis and Capital District Physicians Health Plan, or CDPHP.
Bueck said Jack and Alexa see a pediatrician at UHS Primary Care on River Street where, she said, the doctors spend a great deal of time making sure the patients are well taken care of. She said she pays $18 a month to cover both children.
“It’s a good resource,” Bueck said, “and good coverage. It would be awfully expensive if I had to pay under my insurance. This is much more affordable.”
In order to apply for Child Health Plus, parents can either visit the New York State of Health Marketplace online, or visit a certified application counselor at one of the community-based Health Navigator sites.
Mothers & Babies Perinatal Network of South Central New York, Inc. is one Navigator site where families can enroll. It serves Otsego, Delaware, Broome and Chemung counties.
Theresa Kaschak, director of health insurance programs at Mothers & Babies Perinatal Network of SCNY and a certified Navigator for the Department of Health and Marketplace, said there is no income limit for Child Health Plus. The state provides subsidies for families with incomes up to 400 percent of the poverty level which, for a family of four, would be roughly $94,000, she said.
In Delaware County, 688 children are enrolled in Child Health Plus, including LeAnne Sackett, a 13-year-old from Bloomville. LeAnne’s mother, Mitzi, said she enrolled her daughter in Child Health Plus sometime last August after she changed jobs and was left to find affordable health insurance on her own.
Sackett, a Certified Professional Coach, owns a company called Clearer Image Coaching and also works part-time as a health and wellness coach at a company called Ignite Health. She said LeAnne is covered through Fidelis and called the plan a “really good deal.”
“It’s much better coverage than I had at my last job,” Sackett said. “Then, I was paying $650 every month for health insurance for myself and my family. But Child Health Plus provides very, very good insurance coverage for a very minimal price.”
Sackett said her monthly premium is only two figures and said, with the existence of Child Health Plus, there is no reason why children should not have access to good health insurance. Once, Sackett said, LeAnne had to have a molded mouth guard made, something that would normally cost around $400. But through Child Health Plus, she said, the procedure and mouth guard were completely covered.
According to Medicaid.gov, the Affordable Care Act provided an additional $40 million in funding to continue efforts to promote enrollment in Child Health Plus and Medicaid. However, the website said, many families either do not know about the program or mistakenly believe that their children are not eligible.
Sackett said she is grateful that she knows about Child Health Plus and noted the company’s excellent customer service.
“If you call them with a question, they’re wonderful,” Sackett said. “They treat you with courtesy and are very professional. I would recommend it to a friend.”