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Program promotes health care for low-income families

(Published March 8, 1999)


Staff Writer

Widow Alma Newsome of Northeast Washington said she hadnít been to a doctor since her son was born 14 years ago. Thatís because she didnít have insurance. Today she and her son Daniel receive free health care from a program called D.C. Healthy Families.

Funded jointly by the D.C. and federal governments, D.C. Healthy Families provides free comprehensive health insurance to children and their parents in families with low-to-moderate income who live in the District.

The program is part of the federal governmentís attempt to move people off the Medicaid rolls and into managed health care.

"D.C. Healthy Families made (access to managed health care) possible for all District families across-the-board whose household income is at or below 200 percent of the federal poverty level," said Lynda Flowers, Medicaid policy analyst for the cityís health department.

Parents, grandparents and legal guardians living with a Medicaid/D.C. Healthy Families eligible child qualify for the program. The current income levels for eligibility range from a family of two whose income is $21,700 to a family of four at $32,900. The numbers are adjusted annually.

Adults and children covered under the program receive regular doctor visits, school physicals, home health care and mental health services, according to the D.C. Department of Health. Pregnant women and children younger than 19 living alone also are eligible.

Newsome, 56, went to her first checkup last week at Washington Hospital Center. She said she likes the program and her doctor.

"He told me to walk a mile a day and on the weekends," she said.

According to a fact sheet issued by the D.C. Department of Health, Washington has the 12th highest percentage of uninsured residents among the 50 states and the District of Columbia. There are approximately 15,000 uninsured children and 81,000 uninsured adults living in the District. Flowers said 3,000 people had enrolled in the new health-care program by the end of February. She said the city hopes to receive more applications once information about the new program is placed online in English and Spanish at the end of April.

To qualify, a person must submit an application, Social Security number, proof of D.C. residency, and one monthís worth of pay stubs or a letter from an employer to verify income. Families receive a letter of acceptance or rejection within 45 days. If accepted, they receive a letter asking them to choose a health maintenance organization (HMO). The selected HMO then sends the family a packet including a prescription card and list of participating physicians.

The HMOs available under the program are Advantage Healthplan Inc., American Preferred Provider Plan, Capital Community Health Plan, D.C. Chartered Health, George Washington Health, Health Right and Prudential Healthcare. D.C. Healthy Families also supports welfare to work by enabling welfare recipients to go back to work and not to lose health care benefits.

Transportation to and from medical appointments is provided through the program. Flowers said families enrolled in the program may go to any health care provider that accepts Medicaid.

Applications are available at Giant, Safeway, CVS, Rite Aid, libraries and community-based organizations in D.C.

Copyright 1999, The Common Denominator