Programs help the uninsured

Thousands of Utahns — both children and adults — do not have health insurance. That doesn't, however, mean that they will never need medical treatment.

Help getting needed care when you're uninsured and can't afford to pay is the topic of the Deseret Morning News/Intermountain Healthcare Hotline Saturday from 10 a.m. to noon. Calls will be taken by

several experts representing both the Utah Department of Health and Intermountain Healthcare: Terry Foust, IHC Community Clinics director; Gayleen Henderson, UDOH Children's Health Insurance Program manager; Randa Pickle, UDOH health programs specialist; and John McBride, patient account services director at Utah Valley Regional Medical Center.

One of the largest government programs trying to reduce the number of uninsured focuses exclusively on children. The Children's Health Insurance Program, or CHIP, can insure about 40,000 children a month, up through age 18, said Henderson.

There are openings for about 5,000 children right now and enrollment is open, something that only happens periodically. When that window closes, applicants have to wait until the next open-enrollment period.

CHIP covers a full range of benefits, including well-child care, doctor visits, hospitalization and some dental care. It also has some vision benefits, as well as limited mental health benefits. The coverage it provides is basic, Henderson said.

To enroll, children must be U.S. citizens or legal residents, be younger than 19, and live in families with incomes below 200 percent of the federal poverty guideline, currently $38,700 a year for a family of four. To make it simple, applications are taken in person, by phone, by fax or online.

"An interesting thing a lot of people don't know is we don't count the income of a child," said Henderson, so child support is not counted.

There are small co-payments for services and deductibles, just as with regular health insurance. There's also a quarterly premium of up to $25 per family per quarter.

Adults 19 to 64 who do not have access to affordable health insurance (that means at a cost of less than 5 percent of their income), or who don't qualify for Medicaid or Medicare may be able to enroll in the Primary Care Network, administered by the health department.

PCN has a $50 annual enrollment fee and small co-pays. Its focus is on primary preventive care, so the program will pay for up to four prescriptions a month and offers some dental coverage, as well as doctor visits.