Q: What should you do as a parent if you have an ill child and no health insurance?
A: In the case of a medical emergency, insured or not, take your child to the nearest emergency room. The majority of hospitals are required by law to treat a patient with a health emergency. The Emergency Medical Treatment and Active Labor Act, which was passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act, or COBRA, includes that hospitals and ambulance services must provide necessary emergency health care regardless of citizenship, legal status or ability to pay. Though you may not be able to pay, you still will be legally responsible for the cost of your child’s care. However, you cannot be held criminally liable for not paying, unless you intentionally and knowingly provide false identifying information to avoid paying for care.
You should not rely on emergency room care for all of your child’s medical needs. Hospitals under the emergency medical act are not required to care for nonemergency medical conditions, and they may discharge a patient after the patient has been stabilized and can care for himself or be cared for by another. Because of these limitations, obtain insurance for your child as soon as possible.
Fortunately, under the Affordable Health Care Act signed in 2010, a child’s pre-existing condition must now be covered in a health insurance policy, and a child with chronic health conditions cannot be denied coverage. Adults are not scheduled to receive similar protections until 2014.
If you cannot afford private insurance, then apply for Medi-Cal coverage for your child. If your income or assets exceed the limits for Medi-Cal eligibility, your child may qualify for health care coverage under the Healthy Families Program. This government insurance program offers low-cost health, dental and vision coverage.
Additionally, California Children’s Services, or CCS, is a state program that provides assistance to children with certain diseases, physical limitations or chronic health problems. To obtain CCS assistance, a child must be under 21 years old, have or be suspected of having a medical problem that CCS covers, be a resident of California and be in a family with an income under $40,000 (adjusted gross income on state tax return). A few examples of the many health problems that CCS covers are cancers, diabetes, cerebral palsy and broken bones.
If your child is not experiencing an emergency health problem, there are clinics in San Diego that may treat your child at little or no cost.
For example, Family Health Centers of San Diego accept a broad range of payment and insurance plans. These clinics offer affordable services to all income levels, with a special commitment to low income and medically underserved individuals.
Another option is provided by Volunteers in Medicine San Diego, a nonprofit organization whose mission is to improve access to health care for the underserved and uninsured. This charitable organization is staffed by retired physicians, dentists and other medical professionals who provide care without compensation.
Further, some local hospitals provide medically necessary health care services to patients requiring admission to the hospital at low or no cost.
For example, Rady Children’s Hospital-San Diego is committed to providing care to patients regardless of their ability to pay. Consistent with this commitment, its financial counselors will first work with a child’s family to determine their eligibility for governmental program assistance. State and County eligibility workers knowledgeable in Medi-Cal, Healthy Families and California Children Services assist in determining eligibility and in completing the application process. If a patient does not qualify for a government program, an Rady Financial Assistance Program is in place to provide discounted care to eligible patients based upon their family income.
Another resource that a social worker may refer you to is the San Diego Ronald McDonald House. This charity provides a “home away from home” for children and their families while their child is admitted at any hospital in the San Diego area.
Its Family Care Center also is available during the day to anyone with a child in a hospital. This unique offering provides a place for a family to enjoy a hot meal, relax in a family play area, obtain medical information online, nap, or simply take a break from the often stressful hospital environment.
Additionally, if you are struggling with financial or legal issues while your child is ill, the Professional Alliance for Children may provide relief. The Alliance is a nonprofit organization that aligns professionals — attorneys, Certified Financial Planners, and CPAs — to provide free assistance with these issues. Along with the other charitable organizations described in this article, the Alliance’s mission is to better the lives of children by helping them and their families in their time of need.
All children should receive quality health care regardless of the current financial status of their family. You are not alone when there are resources available that will help you to care for your child.
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