MOUNT VERNON — A little-known program of the Ohio Department of Job & Family Services can help uninsured children who have special health needs when their working parents’ income can’t cover the insurance cost.
The Children’s Buy-In program began in April as part of Gov. Ted Strickland’s “TurnAround Ohio” program, and was organized to insure 5,000 children. To date, however, only three children have met the requirements and been enrolled, one child has dropped out of the program and three more are eligible but their families have not yet paid the first premium.
The CBI program — administered by CareSource Management Group in Columbus — requires that children meet certain medical guidelines, that families meet a family size requirement and that families earn income of more than $42,000 per year, which is 300 percent of the federal poverty level. However, the number of family members determines the final minimum income requirement; thus, a family of four must earn a minimum of $63,600.
Other eligibility requirements are that the child:
•Is younger than age 19.
•Is a U.S. citizen and Ohio resident.
•Is part of a family whose gross income is more than 300 percent of the Federal Poverty Level.
•Has not had any insurance for at least six months before enrolling.
•Is not eligible for Medicaid.
In addition, one of the following requirements must also be met, in that the child:
•Is unable to obtain creditable coverage due to a pre-existing condition.
•Lost the only available creditable coverage due to exhausting a lifetime benefit.
•Would be charged more than twice the state minimum for CBI if the family purchased the only available coverage.
•Participates in the program for medically handicapped children (ODH/BCMH).
Premiums for a family of two earning $42,000 to $55,999 will pay $252.58 per child per month in the CBI program; a family of six earning $85,200 to $113,599 will pay the same amount. A family of two that earns $56,000 to $69,999 will pay $378.87 per child per month.
What about families who earn less than the required $42,000 base income each year but still have special-needs children they cannot afford to insure?
“This program was originally slated to help families with uninsured children whose income made them ineligible for the state Medicaid program,” said Toni Bigby, consumer advocacy director at CareSource. “If families earn less than 300 percent of the FPL, the fall-back program to get coverage for their children is supposed to be the state Medicaid program. Unfortunately, the state Medicaid program currently only covers children in families up to 200 percent of the FPL right now so families are falling into this gap. Ohio did just receive federal approval to expand the Medicaid program to 300 percent of the FPL but since Ohio is in the middle of a budget crisis, this has not happened.”
In other words, children whose parents’ income is at 201 percent to 299 percent of the federal poverty level are “falling through the cracks” at this time by not qualifying for either CBI or state Medicaid.
For families who meet the CBI guidelines, the only way to apply for the program is online at www.jfs.ohio.gov/OHP/cbi/index.stm. The ODJFS processes the applications, then enrolls eligible children in CareSource.
“CareSource is a non-profit Medicaid managed care plan that ensures health coverage for 640,000 Ohio lives and has worked with Ohio’s Medicaid program for almost 20 years,” sad Bigby.
