How to get health care for your children if they live in Washington D.C. Many parents need help paying for health care for their children. If you do not have health insurance through your job, Washington D.C. has programs that may help you get or pay for it. This brochure tells you ways to get help paying for health care for your children. It tells you about:  D.C. Healthy Families (also called Medicaid).  How to get care if you or your child is not a U.S. citizen.  Helpful phone numbers.  Other programs to help you pay for care. D.C. Healthy Families D.C. Healthy Families is Washington D.C.’s health insurance program for low income families. It is also called Medicaid. Most people with D.C. Healthy Families get their medical care through a managed care plan. To get D.C. Healthy Families for your child: The plans are: Chartered Health, UHC Community Health Plan, and Health Care Services for Children with Special Needs. D.C. Healthy Families pays for all your child’s health care needs:  You should not have to pay for any care. This includes doctor and hospital care, dental care, eye care, and mental health care.  You will have to pay $1 for each prescription if your child is not in a managed care plan.  D.C. Healthy Families may also pay for medical care that your child got in the three months before you apply.  Your child must live in Washington D.C.  You must have a low income. For example: Attention: If your income is a little higher than the numbers below, you should still apply. Some of your income may not count. Number of people Your income each month in your family must be less than:* 1 $2,873 2 $3,878 3 $4,883 4 or more For each additional person, add $1005to the number just above * These are the numbers for 2013. They will go up a small amount each year.  Your income can be higher if:  you have high medical bills,  you have work income, or  you pay for childcare.  Your income must be lower if your child is age 19 or 20. Your child must be a U.S. citizen or meet certain immigration requirements to get D.C. Healthy Families. If your child is not a U.S. citizen, see “Health insurance programs if you or your child is not a U.S. citizen” on page 2 of this brochure. Page 1 Health Care for Children in Washington D.C. How to apply for D.C. Healthy Families:  Call the Department of Human Services at 202-727-5355.  Ask them for the address of the office or clinic nearest you where you can apply. Ask what information you will need. Once your child has been approved, you should get one insurance card from Medicaid and another one from the managed care plan, if your child has one. To keep getting Medicaid or Alliance: The Department of Human Services will send you a form. Fill out the form and return it right away so your child’s health insurance does not get cut off. 2/2013 English Other programs to help you pay for care If your child needs a kidney transplant or needs dialysis, or has Lou Gehrig’s disease (ALS): Call the Social Security Administration at 800-772-1213 to apply for Medicare. Medicaid can help you pay your child’s Medicare costs. This part of Medicaid is called QMB. Call 202-727-5355 and ask how to apply. If your child or a family member has HIV or AIDS:  The DC AIDS Drug Assistance Program can pay your child’s premiums and copayments. The program also pays for medicines. Call 202-671-4900 . or visit http://doh.dc.gov/node/137072 Consider buying private health insurance for your child:  This can cost a lot.  When you apply, you will have to answer questions about your child’s health. Your child may need a physical exam.  If your child is under 19 , the insurance company cannot turn your child down because of a health problem your child had before you applied. This is called a pre-existing condition.  If your child is over 19 , the insurance company may turn your child down because of a pre-existing condition. Even if your child is accepted, the insurance may not cover your child’s pre-existing condition. Make sure to ask whether the insurance will pay for all the services your child needs.  If your child has a pre-existing condition and has not had insurance for 6 months or longer, he or she may qualify for the Pre-Existing Condition Insurance Plan. Call 866-717-5826 or visit www.pcip.gov.  CareFirst Blue Shield must offer your child the Blue Preferred Open Enrollment plan. Your child’s health and immigration status do not matter. Call CareFirst Blue Shield at 800-544-8703.  For health insurance companies and plans for DC residents, visit www.healthreform.dc.gov and click on “Insurance Coverage Options.” Health insurance programs if you or your child is not a U.S. citizen Children who are not U.S. citizens can get health care and health insurance in Washington D.C. Applying will not hurt your immigration status or your child’s. Parents’ immigration status does not matter when applying for insurance for your child. Page 2 Health Care for Children in Washington D.C. The Immigrant Children’s Program is for children who cannot get D.C. Healthy Families because of their immigration status. Your child gets the same health care as children in D.C. Healthy Families. Your child must live in Washington D.C., and you must have a low family income. You apply in the same way as for D.C. Healthy Families (see the information under “D.C. Healthy Families” on the first page of this brochure). 2/2013 English Helpful phone numbers For problems with D.C. Healthy Families, DC Healthcare Alliance, or Medicare: Call the Legal Aid Society of the District of Columbia at 202-628-1161. If you do not qualify for legal aid help, call the Bar Association of the District of Columbia Lawyer Referral Line at 202-296-7845. The lawyers they refer you to may charge a fee. Tell them that you have a low income or ask for a reduced fee. If you have a problem with a bill or renewing D.C. Healthy Families: If you need to call your managed care plan: Call the D.C. Healthy Families/Alliance Managed Care Line at 202-639-4030. They can connect you to your plan. If your child has a disability: Call the University Legal Services/Protection and Advocacy Program at 202-547-4747. If your child has a developmental disability and you need referrals for health care or other support: Call D.C. Quality Trust at 202-448-1450. Call Terris, Pravlik & Millian at 202-682-0578 . For any problems with your child’s health care: Call the Office of Ombudsman & Health Care Bill of Rights at 877-685-6391. For information on public health insurance programs and free or low cost health clinics, visit www.ngoziproject.org. Page 3 Health Care for Children in Washington D.C. 2/2013 English