It is important to be informed when choosing a health plan and doctor. Most insured Californians are in managed care plans. A primary care doctor coordinates all your treatment. You have a right to choose your own doctor in your health plan and change doctors if you want. You also have the right to see and copy your medical records and your child’s. It’s a good idea to have a copy, in case you change health plans or doctors. Children get better care when they visit the same doctor each time. They are also more comfortable with people and a place they know.

Things you can do:

1. If you have a problem with your HMO visit www.hmohelp.ca.gov.
2. For health care for people with low incomes, call Medi-Cal Hotline 1-800-952-5294.
3. For low-cost insurance for pregnant women with low and middle incomes, call AIM Program 1-800-433-2611.
4. For low-cost health, dental and vision insurance for children, call Healthy Families 1-800-880-5305 or Kaiser Community Benefits 1-800-255-5053.
5. Community and county health clinics serve almost everyone, including those who have no insurance or are undocumented.
6. For information on choosing and using a health plan in California, visit Office of the Patient Advocate www.opa.ca.gov.
7. For free or low-cost family planning services, call Family Planning 1-800-942-1054. For more information on family planning, women’s health care and pregnancy decisions, visit www.4woman.gov.
8. You can choose who will make decisions about your health care if you can’t. You can also choose what treatments you want or don’t want. Fill out an Advance Health Care Directive. Discuss your wishes with relatives and friends and your doctor. Get a form at your health plan or library.
9. Before you and your children get medical treatment, you will be asked to sign a consent form. Be sure you understand what is being done and why. Ask about risks, benefits and other treatment choices. If you have to make an important decision, take time to think about it first.
10. California Children’s Service can arrange for specialty care for children with costly medical conditions. Visit www.dhs.ca.gov/pcfh/cms.
11. For low-cost eye care for children, visit www.sightforstudents.org
12. To learn about immigrants’ eligibility for health programs, call CHIRLA 1-888-624-4752

FIRST 5 Healthy Kids

FIRST 5 Healthy Kids makes health insurance affordable for the families of over 5,000 kids in Santa Clara County. Created by a public-private partnership with the Santa Clara Family Health Plan, FIRST 5 Healthy Kids offers a low-cost, comprehensive health, dental, and vision insurance program with monthly premiums ranging from $4 per child to a maximum of $18 per family. The program is available to families with children age 19 and under. FIRST 5 funds help provide coverage to children prenatal through age 5 - helping kids get off to a healthy start.

Serves: All regions of Santa Clara County

For more information: www.chikids.org or 408-874-1999

To enroll your child: 1-888-244-5222


Santa Clara County Health and Human Care

Every year Santa Clara Valley Medical Center cares for thousands of patients and provides for over a half-million outpatient and emergency visits. Santa Clara Valley Medical Center (SCVMC) is the only hospital in Santa Clara County with an open door policy guaranteeing residents access to needed medical care, regardless of ability to pay. SCVMC's range of services, national recognition, and commitment to quality make it a valuable community resource. To learn more go to: http://www.sccgov.org/portal/site/vmc/


United Healthcare Children's Foundation Assistance Grants Analysis

Purpose:

The goal of the grant is to facilitate access to health-related services that have the potential to significantly enhance either the clinical condition or the quality of life of the child and that are not fully covered by the available commercial health insurance. This “support” is in the form of a medical grant to be used for medical services not covered or not completely covered by commercial health benefit plans.

The amount awarded to an individual within a 12-month period is limited to either $5,000 or 85% of the fund balance, whichever amount is less. Awards to any one individual are limited to a lifetime maximum of $7,500.

Type of Medical Conditions Included/Excluded: Medical conditions included for grant consideration:

• speech therapy
• physical therapy
• wheelchairs
• hearing aids, etc Medical conditions excluded from grant consideration:
• dental or orthodontic treatment unrelated to a serious medical condition

Application Criteria:

The Regional Board will consider applications based on the following criteria:

• Applicant must be 16 years old or younger and live in the United States.
• Applicant must be covered by a commercial health benefit plan where limits for the requested service are either exceeded, or no coverage is available and/or copayments are a serious financial burden on the family.
• Awards will be granted to individuals in families whose Adjusted Gross Income (AGI) does not exceed $20,000. For example, if you are a family of four, awards are generally awarded to those families whose AGI is less than $80,000, as indicated on the most recently filed Federal tax return.
• Applicant cannot be covered under Medicaid, Medicare, SCHIP (which may be called various names by each state), HIS or other state or federally subsidized health insurance programs given to those without insurance or with low incomes.

A commercial health benefit plan is offered through:

• Commercial (private) employer.
• Individually purchased commercial health plan (small business owners, sole-proprietors, etc.).
• Health benefit plan is offered through your employment with a town, city, state or federal government.

www.unitedhealthcarechildrensfoundation.org/index.html