Shirley Clay knows about the advantages of the Children's Health Insurance Program (CHIP) from two sides.
Not only does she work for the Department of Human Services, which handles the program, but her family has benefited from it as well.
For those who meet the income requirements, CHIP pays for services including vision and hearing screening, immunizations, hospital care, visits to doctors or clinics, lab services, prescription medicines, eyeglasses, hearing aids and preventive dental care. Mental health and substance abuse services also are available.
Clay has six children, ranging in age from 9 to 26 - three in college and three at home. So the insurance has come in handy.
Even if the coverage isn't needed, "it's great peace of mind to know you can provide health care for your child," she said.
"There's just no word for it other than 'thank you,'" Clay said.
CHIP, which was established in 1997 with the enacting of the Balanced Budget Act, is administered by Mississippi Health Benefits through Blue Cross/Blue Shield. It covers most services for young people from birth through age 19, for a year at a time, and is available only to those who have no other insurance coverage.
A family does not choose between Medicaid and CHIP. Rather, Human Services reviews a general application to determine eligibility, which depends on family size, income and age.
The maximum monthly income to qualify is $1,497 for a family of one, $2,020 for two, $2,544 for three, $3,067 for four, $3,590 for five, $4,114 for six, $4,637 for seven and $5,160 for eight. Beyond eight, the figure is increased by $524 per person.
As of Jan. 10, 779 people were enrolled in CHIP in Leflore County and 53,937 in Mississippi.
Dynetha Thornton, director of the Leflore County office, said they are making CHIP forms available in more places in the community and getting the word out about the program's requirements.
Applications are available by mail and at many other locations such as hospitals, health departments and schools.
The department is working all over the community to make people aware of the program. They go to housing developments, churches and civic clubs and also enlist help from fraternities, sororities and other college student organizations.
Last year, these outreach efforts were concentrated in the "April Blitz," but now they are ongoing all through the year.
"Schools everywhere are going to have to get involved in it," Thornton said.
Parents are encouraged to apply for CHIP before a child becomes ill, because, unlike Medicaid, CHIP coverage is not retroactive. The applications may be mailed or taken to the Department of Human Services office in the applicant's county of residence.
Some people are self-conscious about applying, but if they like, they can mail or fax the forms in and never come to the office at all, Thornton said.
"We don't have to associate a face with a name," she said.
Some also have the misconception that CHIP is connected to welfare, but it isn't, she said.
Overall, the goal of CHIP is to "make sure that every child has access to adequate health care," because this care is essential to learning, she said.
One change in the CHIP rules is that recipients must furnish proof of income from the previous month. If they don't have this information, their employers must furnish it.
In the past, recipients have been allowed to declare their wages, but "we realized over a period of time that fraud was built in," Thornton said. Because the information is updated only once a year, if a person reported something inaccurate, it would be recorded for a full year and the office couldn't question it.
Since the rule change, people have been cooperative, Thornton said.
"Now that they know they have to verify, they bring their income verifications in," she said.
Renewing the coverage requires a very small amount of paperwork, but it is essential, Thornton said. Blue Cross/Blue Shield in Jackson sends the forms to recipients asking simply whether they want to renew and whether their income or marital status has changed.
The deadline for recertifying is the 21st of the month before renewal. For example, to renew coverage beginning May 1, the deadline is April 21. However, if the paperwork isn't in by then, the earliest possible day to resume coverage would be June 1.
The Leflore County office has a staff of only three members to visit homes and check on recipients, so it can't cover every family every month. If a parent misses a deadline and a child's coverage expires, "they're not going to know they're closed until they go to the doctor," Thornton said.
Some people never receive the form because they change addresses and don't notify the office, Thornton said.
"If they move, it's important that they report that they've moved," she said.
The office can't close an account unless a child dies or moves out of the state.
Some families are frustrated by the hard-and-fast rule that coverage expires at age 19. Parents of college students become worried because their children might be far away and find themselves in unfamiliar situations without much money. They might have money to buy aspirin, but they aren't likely to have enough for emergency-room care.
Clay said this is especially difficult for those who have been receiving treatment for conditions such as diabetes or asthma for years and suddenly don't have coverage. She said she hopes the program can be modified to help these people.
For more information on CHIP, call the Human Services office at 453-3124. The office fax number is 455-7972. A toll-free number also is available: 1-877-KIDS-NOW (543-7669).
