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Model Application Template for the State Children’s Health Insurance Program

Effective Date:

Approval Date: 8 selected this option.

*As defined by the State Employees Health Plan, for the emergency service definition please see: http://statehealthplan.state.nc.us/policies/PDFs/NCHC_AD0255.pdf

Prior to the implementation of NC Health Choice, there was one public-private program in the state called the “Caring Program for Children.” This program provided basic health services including well-child checkups, physician office visits, emergency room visits for illness or injury, outpatient surgery, diagnostic services, prescription drugs and a toll-free 24 hour nurse line. It did not cover inpatient hospitalization, mental health services, dental coverage, vision and hearing care. Operated through Blue Cross/Blue Shield of North Carolina (with public funds), this program was abolished on September 30, 1998, and the 6,000 – 8,000 children enrolled in the program were recommended for membership in NC Health Choice. Since the demise of the Caring Program for Children, there has been no other public/private partnership in the State.

There are several public safety net programs such as county health departments, federally qualified health centers, rural health centers, etc., that are integral components of the State’s health care delivery system. NC Health Choice works diligently to develop and maintain strong working relationships with each of these entities, in addition to numerous public and private hospitals and family practice centers.

2.2. Describe the current state efforts to provide or obtain creditable health coverage for uncovered children by addressing: (Section 2102)(a)(2) (42CFR 457.80(b))

2.2.1. The steps the state is currently taking to identify and enroll all uncovered children who are eligible to participate in public health insurance programs (i.e., Medicaid and state-only child health insurance):

North Carolina’s outreach program is designed on a community- by-community basis. Each of the state’s 100 counties has an outreach committee designed to identify and reach out to all uncovered children (both Medicaid and NC Health Choice) to find and enroll them.

To encourage both new and continuing Title XIX enrollment in the state of North Carolina: