Bright Idea: Everything You Need to Know About Helping Homeless Youth Apply for Medicaid

A young woman signing up for medicaid on the phone.

In recent months, you may have seen a federal or grassroots campaign to sign young people up for health care coverage under the Affordable Care Act. Although open enrollment for paid insurance plans ends on March 31, eligible youth can still sign up for Medicaid—the government health care program for low-income individuals and families—past that deadline.

Graham Bowman, an Equal Justice Works fellow at The Law Project of the Chicago Coalition for the Homeless, has spent the last five months helping eligible runaway and homeless youth apply for Medicaid. Here’s what he told us about getting them signed up:

Motivate youth to get covered. You’ve likely encountered young people who aren’t convinced they need health care coverage. For example, some young people are more worried about their next meal than thinking about future medical needs. Bowman finds he can motivate some youth to apply for health care coverage by explaining that as Illinois residents, they can apply for the Supplemental Nutrition Assistance Program at the same time.

Bowman says it's easier to convince youth to get covered if they’ve dealt with long waits or racked up big medical bills at the emergency room. For those young people, learning that Illinois will pay most medical debt incurred up to three months before Medicaid enrollment provides an additional incentive.      

Find your state’s Medicaid agency to learn about local resources and provisions that might resonate with youth.

Explain rules that affect eligibility. Youth may be eligible for Medicaid coverage, but they don’t always know it. The Affordable Care Act allows many youth who have been in the child welfare system to retain Medicaid coverage until they turn 26. But Bowman says some youth don’t realize they qualify if they lived with a relative or in another situation they didn’t call foster care. Asking young people where they grew up can help you determine if the provision applies.

On the other hand, young people may be denied coverage because a family member claims them as a dependent on their tax returns—even if the young person hasn’t seen them for years. Bowman recommends asking youth if they know someone claims them as a dependent and then explaining how filing their own tax returns might eliminate the problem.

Sign youth up by phone, rather than online. On the phone, the Medicaid caseworker can take a youth step-by-step through the process, get a sense of the young person’s situation more clearly and rule out irrelevant questions listed on the online form, Bowman says.

That personal touch increases the likelihood youths’ applications are complete and accurate. Using the phone, Bowman says, also lets youth “sign” the application orally and without sending personal documents.

In his experience in Illinois, “Nine times out of 10, young people are immediately approved over the phone just by giving their name, social security number and mailing address,” Bowman says.

Rehearse the call. Before making the call with a young person, Bowman runs through typical questions the caseworker will ask, like whether the youth receives any income and knows their social security number. This initial conversation makes young people less nervous about the process, he says, and reduces the odds that the caseworker will find any discrepancies in their applications.

Let them use your mailing address. Youth will be asked to provide an address where their medical cards can be sent. Bowman encourages programs to receive mail on an applicant’s behalf, and to remind youth they can seek medical attention without a card.

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