1. NAME OF PROGRAM: NC Health Choice for Children

2. PURPOSE OF PROGRAM: This program began in 1998 as part of a national goal to provide health insurance to over 10.6 million children. It is for working parents who cannot afford private health insurance for their children. The program was designed to help working families who make too much money to qualify for Medicaid (Health Check) but too little to afford rising health insurance premiums. If eligible, the children may receive free or reduced price comprehensive health insurance. The coverage is through Blue Cross/Blue Shield and is the same coverage provided for the children of state employees and teachers, plus the added benefit of vision, hearing and dental coverage.

3. APPLICATION PROCEDURES: Applications are a two-page form and are available at the Cabarrus County Department of Social Services, Cabarrus Health Alliance (Kannapolis and Logan locations) and local pediatric clinics. You may also request an application by mail at 704-920-1400. Completed application forms may be submitted to the Cabarrus County Department of Social Services by mail or in person. Receipt of a completed application form initiates the application process. Each child is first evaluated for Medicaid (Health Check) before being evaluated for NC Health Choice. Approved NC Health Choice applicants receive a health insurance card from Blue Cross/Blue Shield for each child, a benefits booklet and instructions in the mail.

4. ELIGIBILITY REQUIREMENTS: To be eligible for NC Health Choice, children must meet the following criteria:

1. Be a resident of North Carolina.
2. Be uninsured. There is a 2-month penalty period for families who cancel insurance. There is no waiting period for children whose parents have lost their insurance coverage through no fault of their own.
3. Be under age 19.
4. Be members of families at or below 200% of the federal poverty limits. The amount of money families can earn and still qualify depends upon the number of people in each family unit. Example: A family of 4 can earn up to $35,304 gross annually and still be eligible if the children meet all other eligibility factors.
5. Be ineligible for Medicaid, Medicare or other federally sponsored health insurance.
6. Be a citizen of the United States or an alien admitted to the United States under a specific immigration status.
7. Pay the enrollment fee if applicable. Families whose income falls between 151% and 200% of the federal poverty limits must pay an enrollment fee of $50 per child up to a maximum of $100 per family. The enrollment fee must be paid each year.

5. OTHER PROGRAM DETAILS: The other program details include:

1. Unlike Medicaid (Health Check), NC Health Choice is limited by the amount of funds that are available. Therefore, the program is open only to children on a first come, first serve basis. The program has been frozen for new enrollment since 1/1/01. However, families are still encouraged to apply if potentially eligible. Applicants are placed on a statewide database waiting list. When the freeze is lifted, children on the waiting list will be removed in the order in which they were placed.
2. Families above 150% of the federal poverty limits must participate in cost sharing and are responsible for co-payments of $5 per doctor visit (except well child and immunization visits), $6 for prescription drugs and $20 for non-emergency ER visits.