Tips for Caring for the Uninsured: A Guide Based on One State’s Possibilities American College Health Association Annual Meeting June 3, 2010 Bev McCoy, FNP Clinician/Clinic Manager Arizona State University Polytechnic Student Health Center Objectives for today’s session: The attendee will be able to: 1. Describe briefly some of the statistics about the uninsured college population. 2. Identify how and where to look for health care for the uninsured. 3. Identify examples of and sources for care for the uninsured. Background 13.7 million uninsured in the 19 to 29 age group (2008 estimate), comprise about 30% of uninsured under 65 years old (per Commonwealth Fund, since 2003, it’s worse every year) Many skip care (76% of uninsured, 2009) or accumulate debt due to care. Many often quit school. (in US News & World Report, Health website, posted 5/21/10) Uninsured Rates Among Nonelderly by State, 2007-2008 NH VT WA MT MN OR WY NV CA AZ MI PA IA NE IL CO KS NM TX OH TN RI VA MD NC DC SC AR AL NJ CT DE WV KY MS AK IN MO OK MA NY WI SD ID UT ME ND GA LA FL HI National Average = 17% <14% Uninsured (18 states & DC) 14 to 18% Uninsured (18 states) >18% Uninsured (14 states) SOURCE: Kaiser Commission on Medicaid and the Uninsured/Urban Institute analysis of 2008 and 2009 ASEC Supplements to the CPS., two-year pooled data. Adults’ Health Insurance Coverage by Family Poverty Level, 2008 Private Medicaid/Public Uninsured 4% 300% + 89% 200-299% 71% 100-199% Under 100% 7% 44% 22% 8% 19% 33% 21% 36% 45% NOTES: The Federal Poverty Level for a family of four in 2008 was $22,025. Family size and total family income are grouped by insurance eligibility. Adults includes all individuals aged 19-64. Data may not total 100% due to rounding. SOURCE: Kaiser Commission on Medicaid and the Uninsured/Urban Institute analysis of 2009 ASEC Supplement to the CPS. Number 94.1 M 28.7 M 30.4 M 30.9 M Barriers to Health Care Among Nonelderly Adults, by Insurance Status, 2008 Percent of adults (age 18 – 64) reporting: 52% No Usual Source of Care No Preventive Care Went Without Needed Care Due to Cost* Could Not Afford Prescription Drug* * In past 12 months. 10% 10% 42% 6% 6% 24% 11% Uninsured Medicaid/Other Public 4% Employer/Other Private 27% 13% 5% Respondents who said usual source of care was the emergency room were included among those not having a usual source of care. SOURCE: KCMU analysis of 2008 NHIS data. Adults’ Health Insurance Coverage by Family Poverty Level, 2008 Private Medicaid/Public Uninsured 4% 300% + 89% 200-299% 71% 100-199% Under 100% 7% 44% 22% 8% 19% 33% 21% 36% 45% NOTES: The Federal Poverty Level for a family of four in 2008 was $22,025. Family size and total family income are grouped by insurance eligibility. Adults includes all individuals aged 19-64. Data may not total 100% due to rounding. SOURCE: Kaiser Commission on Medicaid and the Uninsured/Urban Institute analysis of 2009 ASEC Supplement to the CPS. Number 94.1 M 28.7 M 30.4 M 30.9 M Health Insurance Coverage of the Nonelderly and Low Income Population, 2007 All Nonelderly 261.4 Million Low Income Nonelderly 91.0 Million Uninsured 17% Medicaid/ Other Public 16% Private Nongroup 6% Uninsured 32% Employersponsored Insurance 61% (~159 million) Employersponsored Insurance 26% (~24 million) Private Nongroup 6% Medicaid/ Other Public 36% Note: Low-income includes those with family incomes less than 200% of the federal poverty level. ($42,400 per year for family of four in 2008); Medicaid/Other Public includes Medicaid, SCHIP, other state programs, Medicare and military-related coverage. Source: Kaiser Commission on Medicaid and the Uninsured/Urban Institute analysis of 2008 ASEC Supplement to the CPS. Insurance and College Students 1.7 million uninsured, approximately 20% of college students Characteristics of group similar to uninsured generally $120-255 million in uncompensated care (2005) This and next 2 slides from Elizabeth Redden’s article in Inside Higher Education, March 31, 2008, based on 2008 GAO report on health insurance at colleges College Student Coverage (cont.) 67% through employee-sponsored plans (usually parent’s) 7% other private plans (including student health insurance) 6% public programs Colleges Offering Health Plans 57% offer insurance to students 82% of four-year public 71% of four-year private, nonprofit 29% of 2-yr public Annual premiums range $30 to $2400 Often there are limits such as $2500/incident or $1 million life-time maximum, no drug coverage, services may not be included. ACHA 2007: Colleges Requiring Health Insurance Coverage 1/3 of public and nearly 80% of private colleges require insurance for full-time students With the trend toward fee-forservice funding, many more are considering offering health insurance to students. ACHA 2007: Underinsured 94% Public and 75% private schools are concerned about underinsured students: >$1000 deductible Inadequate prescription or mental health coverage, no catastrophic coverage and other concerns These 2 slides from ACHA Presentation at 2007 Annual meeting in San Antonio, TX “The State of Student Health Insurance: Implications for ACHA Standards by Donna Mills, MPH, Marquette University, 6/1/07 STORIES Lexapro 10 mg for pt with depression—$98.37 (from Costco) Zofran 8 tabs from the ED-- $54! Advair 250/50 for asthmatic who needs it: $216.86 (from Costco) Your stories??? Cover the Uninsured.com Arizona Statistics (per their site) 81.9 % of population w/ health insurance 55.0 % of employers offering health insurance to employees 87.0 % of population that could get medical care when needed 15.2 Patients served by FQHCs as a % of population under 200% FPL To find health coverage in your state On the map, select your state Get: State Profile Guide to Finding Health Insurance Coverage __________ (your state) Guide to Finding Coverage in AZ Step 1 COBRA Have you recently lost your job, had health insurance at your job and your employer had at least 20 employees: COBRA fewer than 20 employees: may get COBRA Must pay total premium. Guide to Finding Coverage in AZ Step 2 COBRA Have you recently had a change in family status (graduated, divorced, legally separated, widowed): --at least 20 employees—COBRA --fewer than 20 employees—may have a right to COBRA www.dol.gov/ebsa/faqs/faq_consumer_cobr a.html or toll-free 1.866.275.7922 Guide to Finding Coverage in AZ Step 3 HCTC Have you recently lost your job because of trade policy (job moved oversees, increased imports): Health Coverage Tax Credit (HCTC) may pay up to 65% of premium for 1 yr Customer Contact Center by calling Toll free 1.866.628.HCTC or at www.irs.gov/individuals/index.html. Guide to Finding Coverage in AZ Step 4 HCTC If you are an early retiree and lost your insurance…. o 55+ years old o Lost pension that was paid by Pension Benefits Guarantee Corp: Health Coverage Tax Credit (HCTC) may pay up to 65% of premium for 1 yr (see contact info above) Guide to Finding Coverage in Az STEP 5 AHCCCS/Medicaid If you cannot afford health insurance… You may qualify for AHCCCS (Arizona’s Medicaid Program) http://www.ahcccs.state.az.us/ and http://www.ahcccs.state.az.us/Publi cations/Reference/IncomeLimits/Eli gibilityRequirements.pdf Guide to Finding Coverage in Az How poor do you have to be for AHCCCS? *If working FT cannot earn more than $5.20/hr or if ½ time $10.40/hr (100% of Federal Poverty Level $10,830) 1 person $10,836* 2 people $14,580 3 people $18,312 4 people $22,056 Guide to Finding Coverage in Az Be sure to ask about other available programs when you contact AHCCCS. More Help Finding Your Way You may want help finding out what programs exist, if you qualify and how to work through the system: Community Legal Services at 800 852 9075. Guide to Finding Coverage in Az KidsCare (Az CHIP) Covers children up to 19th birthday (freshmen?) Must have been w/o insurance coverage for last 3 months Monthly premium based on income: $10-$35 Size Annual Income 1 $21,660* 2 $29,148 3 $36,624 4 $44,110 *200% of FPL http://www.kidscare.state.az.us/English/Default.aspApplicatio nHelp@azahcccs.gov?subject=KidscareApplication Guide to Finding Coverage in Az Serious medical condition or disability: perhaps Medicare Arizona Center for Disability Law at 520.327.9547 or 800.922.1447 or visit www.acdl.com. Guide to Finding Coverage in Az Blind or disabled & have low income or spend most of income on medical care: Medicaid/AHCCCS NOTE: Often denied & need to appeal. For Help: Medicare in AZ 1.800.432.4040 Community Legal Services to find the nearest office 1.800.852.9075 Guide to Finding Coverage in Az STEP 6 Private Insurance Many private companies offer individual and family coverage Brand name companies and unknowns, which can be found by going to an independent health insurance agent Comparison shop CAREFULLY! Private Health Insurance Example 20 yr old woman in Maricopa County Deductible $10,000 7,500 5,000 2,500 1,000 none Monthly Premium $29.66-90.60 $33.47-$86 $56.56-$135 $44.89-$162.93 $97.98-$408 only 1: $136 *from ehealthinsurance.com: all have various co-pays, co-insurance amounts, deductibles and types of coverage (HMO, PPO) Private Health Insurance Example 20 yr old man in Maricopa County Deductible $10,000 7,500 5,000 2,500 1,000 none Monthly Premium $28.39-$70.86 $32.20-$65 $46-$92.35 $43.62-$152.95 $85.28-$165.37 $112.80-$297 *from ehealthinsurance.com: all have various co-pays, co-insurance amounts, deductibles and types of coverage (HMO, PPO) Guide to Finding Coverage in Az STEP 8 FQHC/CHC If you still can’t find coverage… Federally-funded Community Health Centers 17 Az Health centers provide health care regardless of ability to pay and even if there is health insurance coverage. Find the health center closest to you @ http//:ask.hrsa.gov/pc . Arizona Community Health Centers Adelante Healthcare* Mariposa CHC Canyonlands Community Healthcare Mt. Park Health Ctr.* Chiricahua Community Health Centers Native Health* CHCs Yavapai North County Health Ctr. Copper Queen Medical Associates Sun Life Family Health Desert Senita CHC Sunset Family Health El Rio Health Center United Community Health Center Marana Health Center Wesley Community* Maricopa Integrated Health Systems* *5 in ASU campus areas ASU Health Center Plans ASU Bridge Service Plan For $129 per semester fall coverage 8/16/10-1/15/11 spring 1/16/11-8/15/11 Discount on services only at ASU health centers: $10 Office visit $20 lab/x-ray (at Tempe) Specialists at ASU-Tempe (derm, GYN, ENT & Ortho) $30 Bridge Service Plan (cont.) Plan can be used: o alone for uninsured or o If private insurance (personal, parent’s employer’s) won’t cover services at oncampus health center o Greatly reduces price of care for students with high deductibles on their policies. When they enroll in the program, they can predict how much they will pay for services (membership + copay fees). Student Health Insurance Plan Arizona Board of Regents offers a policy to all University Students (ASU, NAU, U of A) 2009-2010 premium $1523 Fall $588 Aug. 16-Jan.3 Spring $935 Jan. 4-Aug. 15 $250 deductible annually HMO Services at ASU $10 office visit No pharmacy coverage Referrals usu. required $10 lab copay $10 x-ray at ASU-Tempe State Programs Check: o State’s Department of Health Services o Association of Community Health Centers o Center for Medicare and Medicaid @ www.cms.gov o Bureau of Primary Care @ www.bphc.hrsa.gov AdultBasic Program-Pennsylvania Family Size 1 Age 1965 $21,660* 2 $29,140* $36/mo. per family member 3 $36,620* *Income levels after earned income 4 $44,100* Adult without children: AdultBasic program Qualified adults pay and dependent care deductions (See plan website for more details) **18 yr olds may qualify for CHIP Veterans Veterans’ Assistance Iraq & Afghanistan Veterans entering college under the GI Bill Health care & drug coverage through a VA medical facility. Student may be eligible for assistance if he/she served on active duty and have an honorable or general discharge. VA Health Benefits Service Center toll-free at 1.877.222.VETS or visit www.va.gov/health. County Health Departments Counties in Arizona (except Gila County) offer clinics for low-income residents. Guide to Finding Coverage in AZ Sliding Clinics Fee include primary care services, pediatrics, women’s health, dental services, behavioral health and sometimes specialty services. http://www.azdhs.gov/hsd/sfsclinics.htm Guide to Finding Coverage in AZ Sliding Fee Scale Clinics A sliding fee schedule (SFS) is used by providers offering discounted fees for services to persons without health insurance. The SFS determines, based on gross family income, the percentage or portion of billed charges that the uninsured client will be responsible to pay Phone: (602) 542-1219 AzDHS, Bureau of Health Systems Development U.S. Sliding Fee Clinic Map @ www.needymeds.com The 11,071 clinics in this database are free or low cost with a sliding scale based on income. Find clinics two ways: Enter the ZIP code to find clinics in your area or click on your state on the map AZ-161 clinics on list OR Menu on Left: Additional Programs—then Free/low cost clinics Links on www.needymeds.com Additional Programs Disease-Based Assistance Government Programs Free/Low Cost Clinics Medicare Information Discount Drug Cards Medicaid Sites State-Sponsored Programs SHIP Sites Federal Poverty Guidelines (has income calculator) Federal Poverty Levels 2010 Family Size 48 contiguous states Alaska Hawaii 1 $10,830 $13,530 $12,460 ($5.20/hr if FT; ($6.50/FT; $10.40/hr if ½ time) $13 ½ time) ($5.99/FT; $11.98 ½ time) So if 20hr/week can’t earn > $10.40/hr—AZ or PA 2 $14,570 $18,210 (total income not >$7 ($8.75/hr if per hr if FT) FT) $16,760 ($8.05/hr if FT) Tips for Caring For the Uninsured Other Sources of Care Indian Health Services Services comprehensive range from primary care (inpatient & outpatient) to tertiary care & specialty In addition: -dental services; -behavioral health; -public health nursing; -health education; and -environmental health services From www.ihs.gov o o o Eligibility? Member of a tribe (enrolled or not)or pregnant with an eligible member or in case of public health concern Live on a reservation or in a clinic service area Where? IHS or contracted health service Few services in urban areas— Phoenix: Native American Community Health Center. Check Urban Indian Health Program directory on web site. Private Entities Mission of Mercy (Maricopa Co.) Mobile clinic, primary care, 3 locations: Maryvale Church of the Nazarene Christ the King Catholic Church Community Center Shepherd of the Valley Lutheran Church More Private Entities St. Vincent de Paul in Phoenix John C. Lincoln Medical Center in Phoenix Neighborhood Christian Clinic in Phoenix Scottsdale Memorial Medical Center in Scottsdale Low-Cost Health Plans The Mercy Healthcare Center Phone number: 602-406-3540 Mission: To provide healthcare to all members of the community through the hospital's Medical Education Program. Description of services: accepts most major insurance plans & also serves qualified lowincome and uninsured patients for full internal medicine primary care and a variety of specialty clinics that include a breast and geriatric medicine, podiatry and dermatology to patients 16 years and older. Another Low-Cost Healthcare Plan FAMILY HEALTH PLAN/SLIDING FEE PROGRAMS of Canyonlands Community Health Center Family Health Plan: for people who lack adequate insurance and have limited income, for access to all the quality health care at Canyonlands Urgent Care& Lake Powell Medical Center. Charge based on individual finances from $15.00 to 75% of the charges. No charge for membership. If you have insurance, it may serve as a secondary payer on the balance due. Requirement: 1)application and 2) Proof of Income (most recent tax return, check stubs, Affirmation of Income, etc.) www.canyonlandschc.org Patients are qualified at different levels, depending on income. B 0-$15 minum C 25% or minimum D 50% or minimum E 75% or minimum F Full Payment For the self-employed/small businesses HEALTHCARE GROUP OF ARIZONA 602.417.6755 or 1.800.247.2289 Eligibility*: -50 or fewer employees; -no group health insurance for the past 180 days -Active business in Arizona for at least 60 days. *N/A ifpolitical subdivision (e.g., a city, town, county) HCG provides multiple products at reasonable prices: HMO (Varying levels of coverage, deductibles and copayments) PPO with expanded pharmacy coverage Dental coverage Vision coverage Discount Cards Discount Cards for Health Services— many! Healthcare Connect—Phoenix a medical discount program Health Care Network at affordable: No monthly premiums. $50 a yr/ individuals; $100 per family/yr Very low fees are due to the health care provider at each visit Enrollment fees are non-refundable. Connect is easy to use: You pay only for services used. Eligibility is not denied because of existing medical conditions Services include: Primary Care Visits Specialty Physician Visits Hospital Services Laboratory & Radiology Services Prescription Drug Discounts Dental Services Discounts Vision Services Discounts Behavioral Health Services Discount You can join HealthCare Connect if: You do not qualify for any other programs, live in Maricopa County, meet income requirements. http://www.healthcareconnect.org/documents/Application%20for%20HealthCare%20Connect.pdf Health Services Discount Card For uninsured employers/employees ANNUAL FEE:$60 PER FAMILY ALMA Healthcare DISCOUNT Card provides access to: ALMA Referral Directory – Discounts of 25% or more primary and specialty care Dental and vision care savings Up to 70% discount* on radiology services, Up to 40% on laboratory services Prescription drug savings Discounted health screens Urgent Care savings Hospital care / prosthetics & orthotics savings Apply on-line: http://www.latinohealthonline.com/alma/cardapp.html Apply by mail: http://www.latinohealthonline.com/alma/cardmail.html Search for the wide network of participating services on-line. A Discount Program in Pima County Pima Community Access Program, (PCAP), not-for-profit agency --access to network of professional health care (doctor except OB, hospitalization, lab & radiology, specialty care, pharmacy discount, transportation discount) --aimed at uninsured (not eligible for any other insured programs ) in Pima County --low membership fee of $40/yr (no monthly fee) Eligibility Hourly Income >100% to 250% Federal Poverty Level (>10,830$27,075) http://www.benefitscheckup.org/ Apply for Medicare Rx Extra Help... 1 If you are one of millions of people with Medicare who have limited income and resources, apply now for Extra Help through Medicare’s Prescription Drug Coverage. Find More Benefits Programs... 2 Find and enroll in federal, state, local and private programs that help pay for prescription drugs, utility bills, meals, health care and other needs. Apply for Benefits... 3 Get applications and fact sheets for over 250 programs that will help pay for prescription drugs, and health care costs. BenefitsCheckUp quickly finds federal, state and private benefit programs available to help Seniors save money on prescription drugs, health care, utilities, taxes, and more. Banner Health Financial Assistance Banner Health Patient Financial Services (PFS) Once a patient indicates an inability to meet their financial obligation, a financial evaluation is conducted Basic Financial Assistance Program Uninsured patients, annual household income of $125,000 or less. This income level is verified by a certification signed by the patient. Patients can qualify for this plan without having to apply for Medicaid assistance. The costs for services are comparable to what many insurance companies charge. o Enhanced Assistance Program serves uninsured individuals with a household income at or below 500% of the Federal Poverty Line. The patient may qualify for substantial discounts or even free care. (Must be denied from Medicaid) Other hospitals have similar programs (Catholic Healthcare West, John C.Lincoln, etc.). www.211.org ALL states, DC and PR except AZ, PA and WY Services to search on site: health care and childcare, job training, education and recreation, retirement, disability and social service information. This Directory contains information on nonprofit and public health and human service programs and some for-profit programs, such as housing. Arizona 211 Line continued Arizona’s 211 system was shut down in an effort to balance the 2009 state budget. Walk-In Clinics For episodic care, the nurse practitioner walk-in clinics, like Minute Clinic, STAT Clinic, CIGNA CareToday, etc., are an inexpensive alternative. They usually have a very LIMITED scope. Check on-line to get more info. Prices are around $35-65 per visit + cost of labs. Women’s Health & Family Planning Title X Family Planning Clinics Title X is the only federal grant program dedicated solely to providing individuals with comprehensive family planning and related preventive health services. approximately 75% of U.S. counties, there is at least one clinic that receives Title X funds, designed to provide access to contraceptive services, supplies and information to all who want and need them. http://www.azfpc.org/ Services are available to both teens and adults. Minors are encouraged, but not required, to involve a parent or legal guardian in their reproductive health decisions. A wide range of family planning services* are available, including: Physical Exams Birth Control Counseling and Education Pregnancy Testing Emergency Contraception STD Testing and Treatment HIV Testing and Counseling Infertility Screening Sterilization - Tubal Ligation and Vasectomy *Abortion is not considered a family planning service and is not provided. Az Family Planning Council (cont.) ***Income qualifications apply. Approved contraceptive methods. Please contact a clinic to see if they offer the method you are looking for: Condom - Male & Female Birth Control Pills Depo Provera Shot IUD NuvaRing® Natural Family Planning Sterilization - Male & Female Diaphragm Spermicide Sponge All Title X funded clinics offer Emergency Contraception (the morning after pill). Call the office in your county. Types of Services that are delegated agencies: County health departments Wesley Health Care Center NP Healthcare- Grace, ASU-DTP College of Nursing and Health Innovation Planned Parenthood of Central & Northern Az Title V The Commonwealth Fund Type of projects Mission: to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including people with low-incomes, the uninsured, minority Americans, young children, people with disablities, and the elderly. Maternal Child Health Services Block Grants Find programs in your state: www.commonwealthfund.org Low-Cost Women’s & Family Planning Services Arizona Kirsten Grina, Program Manager Family Planning Program, 150 North 18th Avenue, Suite 320, Phoenix, Arizona 85007 Phone: (602) 542-0360 Fax: (602) 364-1496 Email: grinak@azdhs.gov The Reproductive Health/Family Planning Project is supported entirely by federal funds from Title V, the Maternal and Child Health Services Block Grant and are available at the following county health departments: Apache La Paz Cochise Coconino Maricopa Mohave Graham Navajo Greenlee Yavapai Yuma Services provided by Az Family Planning Council Well Woman Health Check (Inc. Mammography) ***Partnership with AzDHS + CDC*** Office of Chronic Disease Prevention and Nutrition Services Well Woman HealthCheck Program is a state-wide program that provides free cancer screening to women that qualify. Women on the program may receive: Clinical Breast Exam Pap Test Mammogram Pelvic Exam To qualify, call 1-888-257-8502. To qualify for the Well Woman HealthCheck Program, you must: be a woman, for breast cancer screening (mammogram, etc.), be at least 40 years old (any age if you have symptoms, such as pain, a lump, nipple discharge, an inverted nipple, etc.), for cervical cancer screening (Pap tests, etc.), be at least 18 years old, Un- or underinsured**, and not exceed 250% of FPL Well Woman HealthCheck Program, 150 N. 18th Avenue Suite 310, Phoenix, AZ 85007 1-888-257-8502 (602) 542-7520 Fax Some Locations of Well Woman Health Check in AZ Marcopa County Greenlee County Mujer Saludable Apache County Coconino: North Country Healthcare Pinal County Pima County Navajo County Chiricahua Community Health Center **www.wellwomanhealthcheck.org** 1-888-257-8502 Specialty Care Many Places to Look Specialty Services-Counties/State Cardiac Orthopedics Diabetes Newborn follow ups HIV Services HIV/STD Clilnics TB Clinics Pregnancy Testing Radiation Screening-Coconino County Refugee Health Infectious Diseases Well Child Clinic-Gila County Maternal Child Services: *Preconception Health Information *Prenatal Education *Development assessment to promote early or behavioral health needs. *Child Car Seat Checks *Newborn information on brain development, physical development, nutrition and safety. *Breastfeeding information. Specialty Services-Private Maricopa County: Mission of Mercy Services Available Head, Eye, Ears, Nose and Throat/////Neck Musculoskeletal/////Cardiovascular Respiratory/////Gastrointestinal Genitourinary/////Skin Conditions Glandular//////Psychiatric Children’s Rehabililtation Services 3 sites in AZ: St. Joe’s, Flagstaff & Yuma For “covered” congenital disorders Private Resources Hearing & Vision Lion’s Clubs For Information Contact: The Lions Sight & Hearing Foundation of Arizona 3427 N. 32nd Street Phoenix, AZ 85018 Phone 602-954-1723 or 800-486-0518 E-mail donna@lions-sight-and-hearingfoundation.org Wed site: www.ls-hf.org State Resources-see Az DES website Maternity Services Maternity Services CPLC (Chicanos Por La Causa)Women's Care Center partnership with Phoenix Baptist Hospital (PBH) developed a cash-pay clinic that provides prenatal care to South Phoenix women. FAP y Su Clinica Maryvale Hospital4550 North 51st Avenue #51Phoenix, AZ 85031 623-849-1944 NACA Family Health Center 1500 E. Cedar Ave., Suite 26 Flagstaff, AZ 86004 (between Safeway and Brandy's) Phone (928) 773-1245 Fax (928) 773-9429 North Country Community Health Center offers integrated prenatal and pediatric care for women and children. Oral Health Community Health Centers Sliding Fee Scale Clinics Some private dentists / dental discount programs Community Colleges that offer dental hygiene and dental assistant programs Your dentist? Behavioral Health Services Government & Private Sources Behavioral Health Regional Behavioral Health Authorities (RBHAs), o to administer behavioral health services throughout the State. o health maintenance organization o prevention programs for adults and children o a full continuum of services for adults with substance abuse and general mental health disorders, adults with serious mental illness, and o children with serious emotional disturbance. Tribal RHBAs Gila River Indian Community, Navajo Nation, Pascua Yaqui Tribe and the White Mountain Apache Tribe of Arizona each have an IGA for both Title XIX (Medicaid) and State Subvention Services. Colorado River Indian Tribe has an IGA for State Subvention Services. Services to other Native American Indian Tribes are provided and covered by the local RBHA in which the tribal reservation resides. Agencies serving RBHAs Magellan serves Maricopa County. Community Partnership of Southern Arizona (CPSA) serves Pima, Graham, Greenlee, Santa Cruz & Cochise Counties. Northern Arizona Behavioral Health Authority (NARBHA) serves Mohave, Coconino, Apache, Navajo, and Yavapai Counties. Cenpatico Behavioral Health of Arizona serves Pinal, Gila, Yuma and La Paz Counties. Search Site National Mental Health Information Center. mentalhealth.samhsa.gov/databases Other Behavioral Health Services Head Start screens children and provides services as needed North Country CHC has several behavioral health counselors on our medical team. Chicanos Por La Causa: VIA De Amistad, Centro De La Familia, Corazon Good Fit Counseling Center-Children birth-5 & families; Sliding fee scale, AHCCCS, KidsCare Jewish Family & Children’s Services-low-cost services(602) 256-0528 Pinal-Gila Children’s Services -Jonah Gillooly jonah.gillooly@pgccs.org Mariposa Community Health Center (Nogales Campus) 1852 N. Mastick Way Nogales, Arizona 85621 520-281-1550 Community Health Center-Yavapai County, Prescott Area: (928) 583-1000 Verde Valley: (928) 639-8132 Immunizations Immunizations What is the Vaccines for Children Program? a federal program that provides eligible children all recommended vaccines at no cost (may be charged a small processing fee) doctors and clinics agree to give the vaccines Eligibility: Children from birth through 18 years of age can receive vaccines through the VFC program if they are at least one of the following: eligible for Medicaid without health insurance American Indian or Alaska Native under-insured The savings can be well over $400! VFC For College Students HPV is a covered immunization (also Tdap, Hep A & B, Menactra) If the first dose is given before 19th birthday, the series may be completed. Very important as each dose costs $170 or more! Medication Assistance Medications Medication Zoloft 100 mg (Sertraline) Quantity Walgreen’s 6/1/10 30 $124.9* tabs ($31.99) Costco 6/1/10 $108.36 ($11.15) pack 53 tabs $153.99* $127.92 Singulair 10 mg 30 $137.99* $130.45 Chantix starter tabs Proair HFA MDI 8 gm $44.99* $43.83 Azithromycin 250 mg (generic) 6 tabs $42.99* $8.62* Medications $4 prescriptions-WalMart, Target, Kroger (Fry’s), Sam’s Club, United Drug (Basha’s), Safeway in our area. Check your area. (search $4 prescription medications) I’ve printed a copy and keep it in a binder in the office. Each contains >300 medications. (Each one’s list is about the same.) Medications Discount Drug Card MANY! Just Google. Arizona CoppeRx Discount Card http://azgovernor.gov/coppercard/ind ex.asp $15-55% discount at several pharmacies Rx Card Member McCoy, Beverly ID Number 5171107 rxPCN GN rxBIN 610198 rxGroup GNET11 More Free Drug Cards for Uninsured Merck Prescription Discount Card Pfizer Pfriends Together Rx Access Card http://www.needymeds.com/company_list.taf?_f unction=name&program_id=1107 http://www.needymeds.com/program_list.taf?_f unction=name&program_id=406 http://www.needymeds.com/program_list.taf?_f unction=name&program_id=1127 3-tiered pricing, depending on medication Drug Cards with Premium paid to Needymeds.com Pharmacy Reward Benefits: You pay the pharmacy's lowest price Eligibility: Everyone Cost: Free Contact: www.pharmacyreward.com/needymeds/index.cfm Rx Help for You Benefits: 10% to 65% Eligibility: Everyone Cost: Free Contact: www.Rx HelpforYou.com Some Pharmacies offer discounts to their customers: WalMart, Sams Club, Costco, Walgreen’s Patient Assistance Programs for free or reduced drug costs www.needymeds.com Finding a medication Brand Name List or Generic Name List This list has all the drugs and dosages that are available sorted alphabetically by name. Some drugs are listed more than once because they are available through more than one program. If your medicine is not listed, it's not currently. 3788 medications as of 7/26/07. Drugs are added and deleted often, so check back regularly. www.needymeds.com Click on the first letter of the medication: ABCDEFGHIJKLMNOPQRSTUVWXYZ Chose the name from the list. A program description comes up. (Generally, the patient must be a legal resident or citizen.) Click on the link to “download the application” www.needymeds.com Completing the forms: Read CAREFULLY! Complete ALL fields Advise patient of requirements -have them READ CAREFULLY Some you can apply on-line www.needymeds.com Bridges to Access Glaxo Smith Kline Become an Advocate by calling Order application forms—that contain a coupon for a 2-week supply, available as soon as patient enrolled by phone Renewal Most are for 3 months with renewal each year. Most you simply call to get the renewal or a renewal form is sent with the last 3monthshipment Assistance with PAP Paperwork These services charge the patient a fee for completing the paperwork. There are MANY! Advised patient to call for pricing. (Some charge up to $100 enrollment.) Select Care Benefits Network: $100 application fee then $15/medication per month “America's Leading Patient Advocacy Organization” (2007) The Partnership for Prescription Assistance to help qualifying patients without prescription drug coverage get free or low-cost medicines through the public or private program that's right for them. (2010) PAP Rx Tracker (on needymeds) Data needs to be entered only once Reminders keep users up-to-date Up to four staff members can use the program Web-based program and password protected Pricing no longer on website. (2007: $1-150 $2 ea, 151-299 no additional charge, 300+ $1 each) One Month No Risk Trial Risk-free for an unlimited number of participants for one month. Contact us for more detailed information: email: paprxtracker@needymeds.com phone: 215-965-8291 o Health Care Reform and College Health Health Care Reform Starting in September dependents can remain on parents’ insurance to the age of 26 (even if not dependants or are married)—group and nongroup plans in place 3/23/10 Predicted to increase premiums 1% if the average $3300 annual premium is spread across all family policies Not fully enacted until 2014 (US News & World Reports: Health website, posted 5/21/10) Health Care Reform & Student Health Plans Per ACHA website, unclear exactly how these will fit in but no wording against them. Clarity anticipated before 2014 ACHA’s goal is continuation of comprehensive student health insurance plans. Sources for more Info on Health Care Reform IRS Guidance on Employer-Provided Health Coverage Now Available for Children under Age 27 Kaiser Family Foundation Health Reform website Kaiser Family Foundation, EXPLAINING HEALTH CARE REFORM BRIEF: Questions About the Extension of Dependent Coverage to Age 26, April 2010 Office of Consumer Information and Insurance Oversight (US Department of Health & Human Services) Conclusion I hope you all now: Learned some college health statistics about the uninsured. Could identify ways and sources to locate care for your uninsured students. Can give some examples of sources that can assist uninsured students. Contact Information Bev McCoy, FNP Student Health Center Arizona State University-Polytechnic 7153 East Thistle Avenue Mesa, AZ 85212 480 727 1500 M-F beverly.mccoy@asu.edu