G.I.V.E. for Kids: Healthy Mind, Healthy Body

Health Insurance: Are You Covered?

by Krista Jones, Parents' Source, May 20, 2004

Affordable health care is a concern for most people. This is especially true as medical costs in America continue to rise. Health care now represents the largest sector of the U.S. economy. In fact, health care spending accounts for 15 percent of our gross domestic product. This amounts to a larger share of our economy than food, housing, or national defense, according to federal government statistics. In just the last few years, health expenditures per person rose 24 percent between 2000 and 2003 and they are expected to double in the next decade.*

Medical costs are rising for many reasons. Hospital costs grew by seven percent in 2001. Some attribute those increases to the use of expensive, high-tech equipment and to rising labor costs driven by growing nursing shortages. Prescription drug costs also grew more than 15 percent last year. Americans, relying increasingly on prescription medications, filled 2.9 billion prescriptions in 2000. That amounts to more than 10 prescriptions for every man, woman and child.**

At the same time, health insurance rates increased nationally by 16 ­ 20 percent last year.** As a result, more and more employers are making their employees pay a share of the costs for health insurance. Some employers stopped offering their employees health care coverage altogether.

But the good news is that quality medical care is available - and so is health insurance. In Pennsylvania, it's estimated that 92 percent of children are covered, either privately or through publicly funded insurance programs.***

Having health insurance for your family is critically important. Experts tell us that children who have health insurance generally have better health throughout their childhood and into their teens. They are more likely to receive needed shots that prevent disease, to get treatment for recurring illnesses such as ear infections and asthma, and to get preventative care that keeps them well.

Preventative care means taking your child to the doctor for regular checkups. Doctors and public health officials recommend that every child have about 20 immunizations and eight checkups before age 2, then yearly visits through age 6 and checkups every two years thereafter through age 18. Health insurance covers these visits.

Having health insurance can even affect a child's ability to do well in school. Since children who have health insurance have a better chance of being healthy, they are less likely to miss school. Being healthy also helps them to focus on their studies day to day.

Having insurance means you can pick a doctor for your child and see that doctor whenever your child gets sick without having to worry about how you are going to pay for it. Your child's doctor knows your child's medical history, which will help him or her make a diagnosis and develop a treatment plan for your child's medical condition. You will be able to get the checkups and physicals that enable your child to attend school and play sports. And when your child does get sick, you can get prescription medicines and receive treatment at the doctor's office, rather than sit for hours in an emergency room waiting for someone to examine your child. In fact, the unnecessary or improper use of emergency rooms for non-emergencies is another contributing factor to increased hospital costs overall.

Additionally, people who do not have insurance pay more for their medical care. That's because insurance companies can negotiate discounts for the hospital services and doctor fees they pay, while the uninsured, who don't receive these same discounts, are charged more for medical services. Without insurance, your child's bicycle or skateboard accident can mean a trip to the hospital that can cost you hundreds, even thousands of dollars.

Having health insurance for your children can bring you peace of mind by ensuring your kids get the medical attention they need.

An important program that provides free or low-cost health insurance for children and adolescents who are not covered by private insurance or Medicaid is the Children's Health Insurance Program (CHIP) of Pennsylvania. In Lancaster and Berks Counties, CHIP from Capital BlueCross provides medical benefits through Keystone Health Plan® Central (KHP Central).

CHIP covers checkups and immunizations; doctor visits and prescription drugs; emergency care; hospitalization; dental, vision, and hearing care; mental health and substance abuse treatment and more.

Many Working Families Qualify.

A family of four with an income of up to $37,700 could be eligible for free health insurance for the children. A single parent with an income of $24,980 or less also could qualify. Low-cost coverage is available to a family of four with an income between $37,700 and $44,298. CHIP materials are available in both English and Spanish. Schools and community groups also can request information and ask for outreach staff to explain and help applicants fill out the necessary forms.

For more information, call 1-800-KIDS-101 (800-543-7101). Or email your request to ChipAdultBasic@capbluecross.com. You can find it on the Web at www.capbluecross.com/products/CHIP http://www.capbluecross.com/products/CHIP.

* Centers for Medicare and Medicaid Services

** Medical Cost Reference Guide 2003, Blue Cross and Blue Shield Association.

*** Pennsylvania Insurance Department

Capital BlueCross is an independent licensee of the BlueCross and Blue Shield Association
Krista Jones is the Communications Specialist at Capital BlueCross Corporate Communications

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