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Asthma and Public Insurance

By: Franchis

If you do not have private insurance, several options are available for public insurance. These programs use funds from the federal government but are organized differently in each state. You can learn the specific rules for your area by calling your local county Board of Assistance. Medical Assistance (also known as Medicaid) offers coverage to children under the age of nineteen based on income, residency, and other requirements. Many state Medicaid programs involve managed care plans that have rules about specialty care similar to private insurance plans.

In 1997, the federal government established the Children's Health Insurance Program (CHIP) to expand the availability of health insurance coverage to working families beyond what Medicaid provides. The federal government funds the states to help pay for this program. Since the program is administered by each state, the specific rules may vary in your area. In most states, children from a family of four, with earnings up to $34,100 per year (in 2002), are eligible. More information about the CHIP program can be obtained by calling 1-877-KID-NOW

Some children with chronic diseases like asthma may be eligible for Supplemental Security Income (SSI) as determined by financial and medical criteria. There are strict guidelines, but an eligible child may receive cash assistance as well as medical insurance. Information about SS1 can be obtained through the Social Security Administration at 1-800-772-1213 or through your local Social Security office.

Primary Care

Every child should have a primary care provider for well-child checkups and immunizations. With a chronic disease like asthma, it is particularly important to see consistently the same physician, nurse practitioner, or other professional over time so the primary care provider can get to know your child well. This primary care provider will play the lead role in assessing your child's asthma, prescribing medicines, and making referrals for other services or specialty care if needed.

Primary care providers differ in many ways, including their training background (for example: family medicine, pediatrics, and nurse practitioner programs), the structure of their offices (private office, hospital, or public clinic), and the size of their practice

(a single provider or a large group). Choosing a primary care provider is a personal decision, but several factors are important

to consider when your child has asthma. Experience with young asthma patients: The provider should be familiar with treating asthma in the pediatric age range. Children have many unique needs that require a treatment approach different from that for adults.

Access: Since asthma flares can occur at unpredictable times, you should always be able to reach someone for advice. Many offices are open for evening and weekend hours, which can be very convenient for working parents.

Support systems: Last but certainly not least, the other staff and support services are important. A friendly, accessible office staff and a well-organized system for teaching about asthma, refilling prescriptions, and following through on patients needs can add a great deal to your child's care. Some offices may have specifically trained staff, such as social workers or case managers, available to help with obtaining services. A team approach to primary care has the most to offer.

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