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Hotline focus is insurance

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Health care for people who otherwise would fall through the cracks has been an ongoing priority in the Utah Department of Health, where more than 200,000 Utahns receive some form of assistance with medical coverage through various programs.

While some programs are always available to those who qualify, based on income and circumstances, others offer only periodic enrollment periods. Still, people with medical needs can receive help, health officials say, whether through state-sponsored programs or charity care at area hospitals. Accessing health care is the topic of Saturday's Deseret Morning News/Intermountain Health Care Hotline. From 10 a.m. to noon, health department eligibility experts Elizabeth Heath and Gayleen Henderson, and IHC's charity coordinator John McBride and eligibility counselor Emily Decker will take calls to answer questions about accessing needed health care. All calls are confidential.

Individuals can apply for Medicaid, a state-federal program, any time, said Anna West, health access communication officer in the Utah Department of Health. The Children's Health Insurance Program and the Primary Care Network are both currently full. People who may qualify for those programs need to keep an eye out for announcements regarding open enrollment.

The "message of the day," West said, is a program called Covered at Work, which pays part of the premium for working Utahns who cannot afford the health insurance available to them through their employers. There are more than 5,900 openings in the program.

The only problem with Covered at Work, West said, is that it has to be well-timed. People cannot apply for the health insurance available at work and then get help with the premium reimbursement, because they are not then considered uninsured. They must apply for the program about 30 days before applying for the health insurance, which means being aware of open enrollment periods through work and other factors, she said. Once they qualify for Covered at Work, they can apply for the private health insurance.

The program pays up to $50 a month toward the insurance cost for the employed person and spouse. Children are not covered and would have to qualify for assistance through CHIP or Medicaid.

To qualify, a worker must be 19-64, a U.S. citizen or legal resident and have access to health insurance at work but at cost greater than 5 percent of their income. Individuals who meet all those criteria may qualify. The program uses employer, employee, state and federal moneys to purchase the private health insurance. Application can be made in writing or online at www.health.utah.gov/caw.

Medicaid pays medical expenses (there are some limitations) for people who have low incomes in a number of different categories. Right now, about 160,000 people, including families, children, pregnant women, the elderly, people who are blind and those with physical disabilities are covered by the program. Each category has different income and asset limits, "so if someone thinks he may qualify, he should apply," West said.

CHIP was designed because almost 7 percent of Utah children have no health insurance. Children qualify based on family size and household income. It covers children under 19 who are U.S. citizens or legal residents and not currently insured. Eligible families may be required to pay premiums up to $25 every three months. There are also small co-pays. CHIP currently covers more than 26,000 youngsters. Applications are taken during periodic open-enrollment sessions. But you have to watch for announcements in the media or check online.

PCN is a state health plan for eligible adults, providing medical and dental care to those 19-64 with no other access to insurance. They, too, must be citizens or legal residents and meet income guidelines. Cost includes a yearly enrollment fee of $50 and small co-pays. The program has 19,000 Utahns enrolled. Like CHIP, it's available only during brief enrollment sessions when there are openings.

Information about all of the programs can be found online at www.health.utah.gov or through the toll-free Health Resource Line (which is not the number to call for the health hotline Saturday): 1-888-222-2542.

E-MAIL: lois@desnews.com