How to get health care for your children

How to get health care
for your children
if they live in Northern Virginia.
Many parents need help paying for health care for their children. If you do not have
health insurance through your job, Virginia 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:
 FAMIS-Plus, FAMIS and FAMIS MOMS.
 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.
FAMIS-Plus, FAMIS and FAMIS MOMS
FAMIS-Plus (Medicaid), FAMIS and FAMIS
MOMS are state health insurance programs for
children, teens, and pregnant women.
Your child must be a U.S. citizen or meet
certain immigration requirements for these
programs.
To get FAMIS, FAMIS-Plus or FAMIS MOMS:
If your child is not a citizen, see “Health insurance
programs if you or your child is not a U.S. citizen” on
the last page of this brochure.
 Your child must live in Virginia (even if not
living with you) and must be under age 19.
 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:*
$1,915
1
$2,585
2
$3,255
3
4 or more
For each additional person,
add $670 to 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 very high medical bills,
- you have work income, or
- you pay for child care.
FAMIS-Plus pays for all the health care your child
needs. FAMIS-Plus may also pay for medical care
your child got in the three months before you apply.
FAMIS and FAMIS MOMS pay for:
 Prescriptions
 Doctor’s visits
 Hospital stays, and
 Some other health care services.
You may have to pay a few dollars for some FAMIS
and FAMIS MOMS services.
To apply for FAMIS-Plus, FAMIS or FAMIS
MOMS:
 Call 866-873-2647. Or visit www.famis.org.
To keep getting Medicaid and FAMIS benefits:
FAMIS or the Department of Social 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.
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Other programs to help you pay for care
If your child lives in Fairfax County:
 The Medical Care for Children Partnership pays
for some medical and dental care.
 Your child’s immigration status does not matter.
 You must have a low family income (for example,
$4,070 a month for a family of three in 2013).
 You may have to pay a few dollars for some services.
 Call 703-385-3267. Or go to
www.fairfaxcounty.gov/dfs/ss/mccp.
If your child lives in Prince William County,
Manassas or Manassas Park:
 The Pediatric Primary Care Project pays for some
medical care.
 Your child’s immigration status does not matter.
 You must have a low income (for example,
$4,070 a month for a family of three in 2013 ).
 You may have to pay a few dollars for some services.
 Call 703-792-7348 .
If your child needs a kidney transplant or
dialysis, or has Lou Gehrig’s disease (ALS):
 Call the Social Security Administration at
800-772-1213 to apply for Medicare.
 FAMIS-Plus can help you pay your child’s
Medicare costs. This part of FAMIS-Plus is called
QMB or SLMB. Call 866-873-2647 and ask how
to apply.
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, he or she may qualify
for the Pre-Existing Condition Insurance Plan
(PCIP). Call 866-717-5826 or visit www.pcip.gov.
 For health insurance companies and plans for
Northern Virginia residents, call the Virginia
Bureau of Insurance at 1-800-552-7945
.
If your child has HIV or AIDS:
 You may be able to get free HIV medicines from the
Virginia AIDS Drug Assistance Program (ADAP).
Visit: http://www.vdh.virginia.gov/Epidemiology/
DiseasePrevention/Programs/ADAP/index.htm .
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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 Virginia. Applying will
not hurt your immigration status or your child’s.
Parents’ immigration status does not matter when
applying for insurance for your child.
If your child meets the other requirements for
getting FAMIS-Plus or FAMIS, your child probably
can get benefits if:
your child is a Legal Permanent Resident, or
your child is a refugee, or
your child is an asylee.
Some other immigrants can also get FAMIS-Plus or
FAMIS. Call FAMIS at 866-873-2647. Or call Legal
Aid at 703-778-6800.
Some immigrants can get other programs:
If your child lives in Fairfax County, call the Medical
Care for Children Partnership at 703-385-3267 . Or
go to www.fairfaxcounty.gov/dfs/ss/mccp.
If your child lives in Prince William County,
Manassas or Manassas Park, call the Pediatric
Primary Care Project at 703-792-7348.
If your child cannot get other insurance, find out
about Emergency Medicaid:
Emergency Medicaid covers the birth of your
child and most medical emergencies. Call the
Department of Social Services at 800-552-3431.
Your child’s immigration status does not matter.
Your child must live in Virginia and meet all
other Medicaid requirements.
Helpful phone numbers
For free and low-cost health clinics:
Visit Northern Virginia Health Services
Coalition at www.novaclinics.org.
For legal help:
Call Legal Services of Northern Virginia at
703-778-6800.
If you do not qualify for legal aid help, call the
Virginia Lawyer Referral Service at 800-552-7977.
The lawyers they refer you to may charge a fee.
Tell them that you have a low income or ask for a
reduced fee.
For help dealing with the health care system
for children with certain illnesses:
Patient Advocate Foundation’s Virginia Cares
Uninsured Program. Call 800-532-5274.
The Virginia Department of Health Bleeding
Disorders Program. Call 804-827-3306.
The Virginia Department of Health
Child Development Services
Program. Call 540-891-3151.
If your child has a disability:
Call the Virginia Office for Protection &
Advocacy at 800-552-3962.
For help finding care in Fairfax and Loudoun
Counties and the City of Alexandria:
Call the Partnership for Healthier Kids at
703-698-2550.
For information on public health insurance programs and
free or low cost health clinics, visit www.ngoziproject.org.
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