HOME
ABOUT &
INTRODUCTION
TABLE OF
CONTENTS
  SECTION 1  
Applying for
Health Insurance
  SECTION 2 
Eligibility in
Special Situations
  SECTION 3 
After Application
Approval
  SECTION 4 
Accessing
Health Care
  SECTION 5 
Low Cost
Health Care
  SECTION 6 
APPENDIX A
  SECTION 6 
APPENDIX B
  SECTION 6 
APPENDIX C



HOME
ABOUT & INTRODUCTION
TABLE OF CONTENTS
SECTION 1
Applying for Health Insurance
SECTION 2
Eligibility in Special Situations
SECTION 3
After Application Approval
SECTION 4
Accessing Health Care
SECTION 5
Low Cost Health Care
SECTION 6 • APPENDIX A
SECTION 6 • APPENDIX B
SECTION 6 • APPENDIX C

A Manual for School Nurses and Counselors

5TH EDITION • 2022

TABLE OF CONTENTS

Introduction

  • Health Insurance Programs for Children and Teens in Pennsylvania
  • The Importance of Schools in Helping Families Get Health Coverage
  • Raising Awareness, Directing Families to Assistance in Applying, Helping Families Apply

Section 1 – Applying for Health Insurance

  • Application Assistance over the Phone
  • Online Applications on the State’s COMPASS website
  • Paper Applications
  • Apply In-person

Section 2 – Health Insurance Eligibility in Special Situations

  • Medical Assistance for Children with Special Needs
  • Children Being Raised by Grandparents or Other Caregivers: Guardian and Kinship Care
  • Children in Out-of-Home Placement in the Foster Care System
  • Children in the Juvenile Justice System
  • Children who are Immigrants: Emergency Medical Assistance and More

Section 3 – After an Application is Approved

  • Choosing a Health Plan and Primary Care Provider
    • Tips for Choosing a Primary Care Provider
  • Keeping Health Insurance
  • Reporting Changes
  • Renewing Coverage

Section 4 – Accessing Health Care

  • Behavioral/Mental Health Care and Drug and Alcohol Treatment
    • How to Help Children Get Behavioral Health Care Services
    • Behavioral Health Crisis Services
  • Vision and Hearing Services
  • Dental Care
  • Family Planning Services
  • LGBTQ+ Services

Section 5 – County-Based Free and Low-Cost Health Care Services

The county-based services are: primary care, dental, vision, behavioral health, drug and alcohol, family planning and LGBTQ+ services.

  • Bucks County
  • Chester County
  • Delaware County
  • Montgomery County
  • Philadelphia County

Section 6 – Appendices

Appendix A – Outreach Materials

  • Children First Outreach Flyers
  • School Outreach Activities
  • Sample Social Media Messages

Appendix B – How to Apply for Medical Assistance and CHIP

  • Medicaid and CHIP Eligibility Chart
  • Documents to Send in with an Application (A Handout for Parents)
  • Applying for Medical Assistance for Children with Special Health Care Needs – Category PH-95 (A Handout for Parents)
  • Step by Step Application Guide
  • Applying for Emergency Medical Assistance

Appendix C – Additional Resources

 Free Care for Children with Complex Medical Needs who are Uninsured or Under-insured

  • Shriner’s Hospital: Orthopedic Problems or Spinal Cord Injuries
  • Kelly Anne Dolan Memorial Fund: Grants to Help Family Members with Chronic or Terminal Illnesses
  • Western Association for a Serious One-time Medical Need
  • Help with Medications

Application Denials and Due Process Rights and Appeals

Denial of Health Care Services – Appeals, Grievances, Fair Hearings, External Review