Healthy Montana Kids insurance program reaches out to tribal nations

By B.L. Azure

There are more important reasons to enroll in Healthy Montana Kids than the prizes offered by THHS. For instance it helps relieve the financial stretch on the THHS dollar by channeling eligible applicants to the free or low cost health coverage program. (B.L. Azure photo)

ST. IGNATIUS — Third party billing. That is the mantra of the Tribal Health and Human Services Department as it navigates its future. The more THHS can bill third parties for the services it provides to patients in its clinics the better it is for their bottom line. A healthy bottom line means THHS can re-channel its funds towards investment in its human and facility resources. That in turn leads to improved services for THHS clientele and that in the end benefits all parties involved especially the children.

There are various avenues - Medicare, Medicaid, private insurance - to third party billing for the services THHS provides in its clinics. Now there is another one. It's called Healthy Montana Kids (HMK) and it provides free or low cost healthcare coverage. There are no co-pays for eligible Indian children.

The Confederated Salish and Kootenai Tribes and the other tribal nations in Montana are involved in the State managed via the sovereign government-to-government relationship. The CSKT and the Montana Department of Public Health and Human Services entered into an HMK agreement in April.

THHS is currently seeking to enroll as many eligible families in the HMK program in order to, among other things, loosen the strain on less-than-adequate Indian Health Service funding. For people uninsured or under insured the IHS is the payer of last resort. It doesn't take long to put strains on its budget; that is why Indian people eligible for other health insurance programs should take advantage of them.

"This is a good program, an economical way for those eligible to get insurance," said Diane Matt, THHS HMK coordinator, reiterating that there are no co-pays for eligible Indian families. "We want to get as many people as we can enrolled in this (insurance) program by December 30. The Indian Health Service has limited amounts of money. They'll have more money left for other healthcare needs if the people eligible for this program enroll in it. That is why it is so important for people to enroll in this."

Matt said the application is easy and that applicants only need to provide the completed form with two months of check stubs for income verification. THHS will assist eligible families with the application process. The income requirements have changed so that more families are now eligible for HMK. Presently families with an income 250 percent or less of the federal poverty level are eligible. Once the application is done it is sent to the DPHHS in Helena.

Children up to age 19 are eligible for Healthy Montana Kids. They must be Montana residents as well as a United States citizen or qualified alien. There is income and other guidelines however there are also waivers in many of them.

For some families, depending on income, children must be uninsured for three months (there are waivers for Native American children). For some families, depending on income, the child's parent or stepparent may not be employed by the State of Montana or the Montana University system. A household must meet income guidelines for household size to be eligible.

HMK covered services, among other things, include,: office and clinic visits; emergency services; hospital services; sports or employment physicals; anesthesia services; surgical services; well-child checkups; prescription drugs; laboratory and X-ray services; mental health services; substance abuse services; dental services; vision exams and eyeglasses; and hearing exams and hearing aids.

There will be a drawing for children prizes Friday, September 24, for those who enroll in the HMK healthcare coverage through THHS. The prizes include a bicycle, children's games and toys, DVD player, water sports equipment, gift certificates and more. All families who enroll will be awarded a Wal-Mart $25 gift certificate.

For more information on Healthy Montana Kids, call Diane Matt or Carla Tanner at 745-3525.