IN THIS ISSUE...
1. What is the CKSN Update?
2. Case Tip: Using Medicaid to Pay for Costly Procedures
3. Health Insurance Guidebook Available
4. Program Update:  2003 Federal Poverty Level Guidelines Forecast
5. Health Care Reform Lobby Day
6. Circles of Life Conference
7. HealthWatch Updates
1. What is the CKSN Update?
For those of you who have recently subscribed, the CKSN Update is a bi-weekly electronic newsletter of the Covering Kids with Special Needs project that ABC for Health is implementing with its partners, the Title V Children with Special Needs Regional Centers and Family Voices - Wisconsin.    This update will feature advocacy tips, case studies, regulation and policy updates for health care financing issues, and will provide announcements from the HealthWatch committees and related organizations.

If you would like to include news and information in future CKSN Updates, please send it to the attention of Barbara Katz, Parent Consultant, ABC for Health, barbk@safetyweb.org If you do send stories and/or health care access and coverage tips, please limit each submission to 150 words.

2. Case Tip: Using Medicaid to Pay for Costly Procedures
If your child needs to have a procedure or surgery done that your insurance will not cover, you should consider applying for Medicaid even if you believe your income is too high to qualify. One special feature of Medicaid (the Family Fiscal Unit or FFU) permits an "individual" income determination if there is a stepparent, stepchild, pregnant woman, or a child with income in the household. This special test could result in a child becoming eligible even in a higher income household or dramatically reducing the Medicaid deductible amount.

For example, assume a ten-year-old girl needs a cochlear implant, however her private insurance through her father's employer will not cover the procedure.  The procedure will cost an estimated $55,000. Since, cochlear implants are a covered service under Medicaid, her parent's can apply for Medicaid for their daughter.  Also assume that the child has one sibling, the family income is $55,000.00, and the child has a savings account drawing interest.

Because the girl is over six years old, and already has insurance, she will be tested for Healthy Start OBRA, which has strict income guidelines at 100% of the federal poverty level.  The parents must request that a deductible be calculated for their daughter.  Since the girl has a savings account that is accruing interest, her parent's should request that a Family Fiscal Unit be calculated.  This means that the parent's income will be divided by four, since there are four members in the household.  This family is also eligible for working adult deductions and childcare deductions.    

After all calculations are done, the daughter's FFU six-month Medicaid deductible is an estimated $5,367.00.  This means that her parents are responsible for just $5,367, and the providers must bill Medicaid for the remainder. If the family has any other medical bills for anyone in the household, including insurance premiums for the six months of the deductible period, those bills can also be used to meet the Medicaid deductible. This reduces the family's out of pocket expenses for the surgery even further.  

3. Health Insurance Guidebook Available
The Health Insurance Guidebook provides basics about health insurance policies, insurance claims and denials, legal protections for consumers, and resources for additional assistance.  This book is available for download, free of charge, on the ABC for Health website, http://www.abcforhealth.org

4. Program Update:  2003 Federal Poverty Level Guidelines Forecast
2003 Federal Poverty Level Guidelines Forecast 
On February 7, 2003, the Federal Government published new Federal Poverty Guidelines for 2003. According to Federal rule, these guidelines are effective when published. In Wisconsin, changes necessary to update the eligibility system delay the effective date of these income guidelines until May 1. If this delay affects your eligibility, contact ABC for Health, a local advocate, or your county or tribal human services agency to discuss how best to seek eligibility for you and your family.
Do not assume you are ineligible if you are over these published income levels.
Monthly Income Level Comparison between 2002 and 2003 Limits
Size of Family
100% FPL

2002 

Healthy Start Children Ages 6 - 19
100% FPL

2003 

Healthy Start Children Ages 6 - 19
185% FPL

2002

BadgerCare & Healthy Start for:
* Pregnant Women
* Children Under Age 6
185% FPL

2003

BadgerCare & Healthy Start for: 
* Pregnant Women
* Children Under Age 6
* Family Planning Waiver Program for Women age 15 - 44
1
$738
$748
$1,365
$1,384
2
$995
$1,010
$1,840
$1,868
3
$1,251
$1,271
$2,315
$2,352
4
$1,508
$1,533
$2,790
$2,836
5
$1,765
$1,795
$3,265
$3,320
6
$2,021
$2,056
$3,740
$3,804
7
$2,278
$2,318
$4,214
$4,288
8
$2,535
$2,580
$4,689
$4,773


For more information on these figures, please visit:
http://aspe.hhs.gov/poverty/03fedreg.htm.

5. Health Care Lobby Reform Day
Wisconsin Citizen Action is hosting a Health Care Reform Lobby Day on March 12 beginning at 9 am at the Orpheum Theater at 216 State Street in Madison.  The daylong activities will feature a 12:20 p.m. rally on the steps of the State Capitol.  For information and registration, contact Sam Gieryn at 608.256-1250, ext. 13, or visit Wisconsin Citizen Action's web site at http://www.wi-citizenaction.org

6. Circles of Life Conference
Wisconsin's annual conference for families of children with disabilities will be held on May 1 and 2 at the Olympia Resort and Conference Center in Oconomowoc, Wisconsin.
This conference is for families who have children with disabilities and the professionals who support and provide service for them. Parents and professionals will be representing their own perspectives, sharing experiences and approaches they have found helpful. For further information and to download this year's brochure, visit www.wfv.org

7. HealthWatch Update
The Southern Regional CKSN HealthWatch group will have its initial planning and brainstorming meeting this Monday, March 3, from 11:30 - 1:30 pm at the South Madison Health and Family Center (Harambee Center) at 2202 South Park Street in Madison.  If you are interested in attending, please contact Barbara Katz at ABC for Health, barbk@safetyweb.org Lunch will be served and a modest stipend for parents is available.

The Polk County HealthWatch Coalition will have its next meeting on Thursday, March 13 at 10:45 am.  The focus of the meeting will be on dental access, and a lunchtime presentation will highlight the proposed Asthma State Plan.  For information on this meeting, contact Mike Rust, at 715.485.8525 or miker@co.polk.wi.us

The CKSN Update is published on the 1st and 15th of each month.  If you are interested in joining a CKSN HealthWatch coalition in your region, please contact Barbara Katz at
barbk@safetyweb.org 

ABC for Health, Inc.
Barbara Katz, Parent Consultant
152 West Johnson Street, Suite 206
Madison, WI  53703
608.261.6939 ext 207