The UNC Kidney Center is developing a program to help teens get ready for their transition from pediatric to adult healthcare. This program is designed for patients between the ages of 11 to 21. We know that this transition requires the patient to prepare to see an adult kidney doctor and to become responsible for his/her own healthcare needs. This responsibility includes things like scheduling appointments, taking/refilling medication(s), and finding insurance. Our aim is to provide our patients with the knowledge and encouragement necessary to make this transition as smooth and successful as possible. We have designed our new program to assess what patients do and do not know about their healthcare, and then teach and explain everything they need to know. One way we begin this process is through creating a patient’s Medical Passport. This passport helps the patient keep track of his/her diagnosis, medications, and allergies. This is just a first step in assuming full responsibility as an adult, and we aim to help each of our patients to transition successfully into adulthood.
For more information, please contact Kristi Bickford, Transition Coordinator, at 919-966-2561 ext. 246, or by e-mail: kristi_bickford@med.unc.edu
Health Insurance Frequently Asked Questions
So, what is health insurance?
Health insurance is a program that helps to lower the cost of a person’s health care – things like medication, doctor’s visits, lab tests, hospital stays, or dialysis. Unfortunately, those things can be very expensive, so people need help to afford the cost of staying healthy. People may get health insurance through private companies, employers, or a government program like Medicaid.
What is a health insurance provider?
There are many health insurance providers. They are private companies and government agencies that cut us a break when it comes to paying our medical bills, which are often expensive. Every provider has a different name with slightly different rules, but the overall goal is to keep us healthy at an affordable price. Providers help us from having to pay for our entire bill. Instead, we are usually required to pay a small portion of most medical bills, and our insurance provider will most likely cover what’s left.
Some of the government providers are listed here so that you can understand who they are and if you might even qualify for one:
- Medicare is a program which covers health costs of adults over the age of 65 years, and certain adults and children who are less than 65 with long-term health conditions, including ESRD. Click here to learn more about Medicare for children/young adults with kidney disease.
- Medicaid (different from Medicare) is available to assist different groups based on income level. It is different for each state, but families with children, pregnant women,the elderly, and the disabled qualify for this form of financial help. Click here to learn more about Medicaid.
- SCHIP (State Children’s Health Insurance Program) provides health care for children whose parents cannot receive health insurance from Medicaid. Click here for the NC SCHIP program (called NC Health Choice).
- Military Health Plans are available to men and women in the military and their families. There are different plans provided for soldiers depending on their status in the military, such as active duty soldiers or retired veterans.
- State Health Insurance Plans are provided by some states for people with low-incomes. Unfortunately, North Carolina does not have this type of insurance, but our state does sponsor many programs to give better health care and lower its cost.
What if I don’t qualify for a government health insurance program?
There are many private health insurance companies as well. These usually require a monthly fee (nothing is free all the time!), but when your health is bad, the monthly fee is nothing in comparison to your total medical bill. People are able to receive private health insurance from their job. This works because the insurance companies are willing to sell insurance plans for a lower monthly cost when businesses offer to buy many insurance plans for their workers all at once. The employees (you and I) then pay the reduced price each month and everyone saves some money. It is also possible for individuals and families to buy a health insurance plan on their own, but this option usually comes with a high price tag. In most cases, each provider looks at your income and your health, and then offers the health insurance best-fitted to your needs.
How do I know if I have health insurance?
If you are under the age of 18, you are able to be covered by the health insurance of your parent(s) or guardian(s). If your parent(s)/guardian(s) do not have health insurance, then you may be eligible to be covered by a government program such as Medicaid or Medicare. If you do not know what kind of health insurance you have, ask your parent.
“I’m 18 or older … what does this mean in the health insurance world?”
When you become older than 18, most insurance programs will only continue to cover you under your parent(s) plan if you are a full-time student. If you are older than 18 and are no longer in school, you will need to consider the following options: apply for private health insurance on your own, apply for a government health insurance program, or get a job that offers health insurance as a benefit. If you have a job, an important question to ask your supervisor is whether or not they offer a health insurance plan. Most do, and are more than willing to help you get started. If this is not an option, or you do not have a job, hopefully you qualify for a government program listed above. Not having health insurance is taking a huge risk, one that could result in very expensive medical charges and medical decisions based on money instead of your health.
Helpful Forms
Supplemental Security Income (SSI) And Children
What is SSI?
The SSI program is supported by the government and provides monthly income to people who are:
- Age 65 or older; or
- Blind; or
- Disabled,
And who:
- Have limited income; and
- Limited resources; and
- Are U.S. citizens that reside in one of the 50 states, including
the
District of Columbia, and the Northern Mariana Islands.
What does "disabled" mean for a child?
An individual under age 18 is "disabled" if he/she has a medically determinable physical or mental impairment which:
- Results in marked and severe functional limitations; and
- Can be expected to result in death; or
- Has lasted or can be expected to last for a continuous period of not less than 12 months.
Who is a “child” for SSI?
A person who is neither married nor head of a household and:
- is under age 18; or
- is under age 22 and is a student regularly attending school.
How does the SSI disability program work for a child?
To be eligible for SSI benefits, a child must be either blind or
disabled. A child may be eligible for SSI benefits based on disability
from the date of birth; there is no minimum age requirement. A child may
be eligible for SSI benefits based on disability until attainment of age
18.At age 18, a person’s impairments are evaluated based on the
definition of disability for adults At any age, a person with a visual
impairment may be eligible for SSI benefits based on blindness if the
impairment meets the definition of blindness.
How do I apply for SSI benefits for my child?
With an appointment, a Social Security Administration representative
will help you apply for benefits. To make an appointment, you may call
their toll-free number,
1-800-772-1213, between 7 a.m. and 7 p.m.,
Monday through Friday. If you are deaf or hard of hearing, you may call
their TTY number, 1-800-325-0778. Be sure to have your Social Security
number ready when you call.
You may choose to file the claim either by phone or in person at a local social security office. You may also visit an office to apply without making an appointment, but you may have to wait awhile to speak to a representative. Information concerning locations of local offices can be found on the website.
If you need a language interpreter, we will provide free interpreter services to help you conduct your Social Security business over the phone or in any Social Security office.
Useful Documents from the Social Security Administration:
