アメリカ西海岸の小さな町で　付き合い丸28年の2人
彼氏Dさん&台湾出身の元保護犬Coco(2020年没)と共にひっそりと　
慎ましく暮す男の地味でありふれた　日常生活日記


コメント歓迎です～☆　 　ゲイの方　大歓ゲイ☆ 　 リンクはご自由にどうぞ～♪

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不法移民と健康保険

先週末ボランティアに参加してきました～　仕事関係の知り合いが市が主催のイべントのボランティアを探していましたので、たまには社会貢献もいいか～ということで行ってきたのです。このイベントは不法移民者への情報イベントといった感じのもので　非合法的に米国に住んでいる人たちへの法律、健康、教育についての情報を提供するものでした。







米国における不法移民　非合法移民にはいろいろな呼び方がありましてかつてはillegal immigrants(違法移民？)と呼んでいましたが最近は政治的な意味合いもありundocumented immigrant(書類のない移民？)と呼ぶことが多くなっているようです。日本と違い歩いて国境を渡ることのできる米国にはこのundocumented immigrantの人口が多く様々な社会的な問題を投じています。

このundocumented immigrantについて個人的にはいろいろと思うことがありますので正直には両手放しで彼らをサポート＆助けるべきだ～と言う気持ちにはなりませんが　もうこちらに来ている以上は人間としての尊厳は守られるべきだとも思いますので今回のイベントも自分なりに納得してボランティアをしてきたという背景があります。

でも考えてみてもこれらのundocumented immigrantの人たちは強制送還を恐れているので常に人の目を気にしている部分もありなるべく目立たないようにひっそりと暮らしている人が多いため公の場所に集まること自体があまりありません。そのためこのように市が主催のイベントにはなじまないようで来る人たちもまばらでした。

米国の undocumented immigrantの人たちは中南米からの人が多くほとんどがスペイン語を話しますが、実は訳ありでこちらにundocumented immigrantとして住んでいる日本人も意外と多くいたりします。以前は同性婚ができなかったため男性を好きな男性が彼との生活を守るために undocumented immigrantになってまで米国に居座っていたケースもちらほらと聞きました。

日本から来た留学生が他の国からの留学生と結婚しこちらに生活基盤を作ったもののお互いの国に暮らすことが困難で米国にundocumented immigrantとして住むケース。たとえば日本人の女性がアフリカからの男性と結婚したが彼は日本語が喋れないため日本での生活力がない、一方女性の方も貧困にあえぐアフリカの方で住むという思い切りがつかないなど。。。

人それぞれの状況と価値観ですのでいろいろなライフスタイルがあるので一概にどれが正しいとか間違いとかここでいうつもりもありませんが米国でundocumented immigrantの暮らしは収入面でも買いたたかれたり、社会的保障でもあまり恩恵を被ることができない場合があるので楽なものではないと察することができます。









さて今回のイベントでの僕の担当は健康保険についてのブースでした。米国では日本のように国民皆保険がなく、個人的に保険を買うと月に何十万円もの保険料がかかり非保険の人が沢山いました。オバマ政権の下で健康保険についての改革がありそれ以降沢山の人が政府の補助を受けて健康保険に介入することができたのは素晴らしいことではありますが、当然のことながら

この政府主導型の健康保険改革は基本的に米国に合法的に住む人のためのものでundocumented immigrantの人たちにまで保護を広げておりません。書類がないつまり法律上この人たちはこの国に存在していない建前ですので当然といえば当然のことなのです。しかしながら法律上存在しない彼らも実質的には存在しており建前と現実のハザマにいる状態。

SFベイエリアでは大変革新的な人が多く彼らの健康も守っていこう～ということで各群が主になってundocumented immigrantにも保険のようなものを提供しています。厳密には保険と呼べるものではないのですがそれに準ずるものでほぼ保険とみなしても問題はないものでこの恩恵を享受する資格としては基本的にその各County(群)に住んでいればOKというゆるい規定。







この各郡主導型の健康保険に加入すれば格安で医者にかかることができますし、移民局とのつながりが全くないので安心して気軽に医療サービスを受けることができるのです♪その時にいただいた情報が広範囲にわたってなかなかいい情報でしたのでここのブログの方に情報として載せておこうと思います。

日本人に限らず　もしお知り合いでundocumented immigrantとなり怪我や病気の時に保険がなく不安な状況になっている人たちに是非Copy&Pasteで結構ですのでシェアしてあげてください～ただしこれは低所得者用にデザインされたプログラムなので合法的なビザ　例えば学生ビザ(発給にはある程度の銀行口座残高の表示義務があるため)や駐在員ビザを持っている場合は

高所得があるとみなされてこのプログラムには参加できないという規制もありますので詳しくは自分の住む地域の担当者へ連絡してみてくださいな。このプログラムは住んでいる場所によって変わる部分がありますが基本的には非合法に住んでいる方なら誰でもOK。子供がいる場合それをはっきりという方がいいでしょう。ベネフィットがより多く受けられます♪

Health Coverage for Counties

San Francisco County

Healthy San Francisco
A county program created for uninsured San Francisco residents to access health services affordably regardless of immigration status, employment status, or pre-existing medical conditions.
Do I Qualify?
•    Combined family income at or below 400% of the Federal Poverty Level. 
•    A San Francisco resident who can provide proof of San Francisco residency with the intent to reside permanently.
•    Uninsured for at least 90 days
•    Not eligible for public insurance programs such as Medi-Cal, or Healthy Kids™
•    Age 18 or over
For more information visit www.healthysanfrancisco.org or call HSF Customer Service:  [phone]
•    Customer Service representatives are available Monday – Friday, 8:30am – 5:30pm

San Francisco Health Plan’s Healthy Kids
Healthy Kids offers complete medical, dental and vision insurance for children at a very affordable cost – regardless of immigration status.
Do I Qualify?
•    Uninsured
•    Under 19 years of age
•    San Francisco resident
•    US Citizens, nationals, eligible qualified immigrants or undocumented immigrants
•    Must not be eligible for Medi-Cal
•    Within the income guidelines

For more information contact our Healthy Kids Enrollment Team at [phone].


Alameda County

HealthPAC
What is HealthPAC?
 HealthPAC (the program that replaced CMSP and ACE) provides comprehensive health care services through a contracted network of health care providers. Health services are provided through the HealthPAC Provider Network, which includes the Alameda Health System and primary care community-based organizations.
 
You may be enrolled in HealthPAC if you have a card that looks like this.
Who does it cover?
 In order to be eligible for HealthPAC coverage individuals must:
     Be a resident of the County of Alameda
    Have a gross monthly income at or below the 200% Federal Poverty Level
    Not be enrolled in or eligible for full- scope Medi-Cal
    Not be enrolled in private or employer-based insurance
How do I apply?
 If you think that you may be eligible for this program, contact one of the following providers. When you call one of the providers you should expect to go through an eligibility screening process. If you have questions about the program or eligibility requirements, please call HealthPAC Customer Service at 1-877-879-9633 or email [e-mail].  (This is not a secure e-mail. Do not put personal health information in the e-mail.)
 
If your HealthPAC application is approved:
     HealthPAC will mail you an ID card. If you lose your card you will not need a new one.
    Read the HealthPAC participant handbook to find out how HealthPAC works and how to get care.
    Make sure to renew your HealthPAC by the “Renewal Date” on your ID card.
 
Where can I get more information?
     Call HealthPAC Customer Service at 1-877-879-9633, Monday – Friday, 8:30 A.M. – 5:00 P.M.
    Email at: [e-mail] This is not a secure e-mail. Do not put personal health information in the e-mail.
    See the HealthPAC Brochure and the HealthPAC Participant Handbook for more information on the program.


Santa Clara County

Ability to Pay (APD) Program
The Santa Clara Valley Medical Center's (SCVMC's) Ability to Pay Determination program (APD) is a program for low-income patients who are Santa Clara County residents who do not qualify for Medi-Cal or do not have other insurance coverage. Those who qualify for APD will have co-pay depending on income level and not all services are covered under APD.

Do I Qualify?
•    Be age 21 or older
•    Be a Santa Clara County resident
•    Undocumented resident with five years of residence in Santa Clara County qualify.
•    Individuals on VISAS do not qualify but may be eligible for discounted charges.
•    Not be eligible for programs such as Medi-Cal or Medicare
•    Not have other health insurance
•    Not expect payment to be made on behalf of the individual by any other person or company
•    Meet low-income criteria
For more information visit http://www.scvmc.org/ or call Patient Access Department: 1-866-967-4677          
770 South Bascom Avenue, San Jose, CA 95128

Santa Clara’s Healthy Kids:
Healthy Kids Covers children in Santa Clara County under age 19 (including undocumented children) with family income at or below 300% of the Federal Poverty Level (FPL).  It is a locally-funded health insurance program established to provide low cost comprehensive health coverage to uninsured children in Santa Clara County. Citizenship or legal immigration status is NOT required. There is NO property limit and NO property verification is required.
Basic Eligibility Requirements
•    To qualify for the Healthy Kids Programs, Children must:
•    Reside in Santa Clara County
•    Be under age 19
•    Be INELIGIBLE for Medi-Cal or Healthy Families insurance
•    Have family income at or below 300% of the Federal Poverty Level (FPL)
•    Have no other health insurance.
Note: Children who receive restricted Medi-Cal benefits may qualify for Healthy Kids; however, children who currently receive full scope Medi-Cal benefits with a share of cost are not eligible for enrollment. A share of cost is similar to a monthly deductible. It is the amount of medical expenses that a Medi-Cal beneficiary must pay or be obligated to pay before Medi-Cal will cover any medical expenses.
For more information call the Children’s Health Initiative toll-free phone line at 1-888-244-5222.


San Mateo

San Mateo County ACE Coverage Program
The San Mateo County Access to Care for Everyone (ACE) Program is a health coverage option available at the San Mateo Medical Center main campus and clinics and the Ravenswood Family Health Center. San Mateo County ACE is not an insurance program. It provides a set of health benefits for uninsured adult residents of San Mateo County, age 19 and older, with incomes at or below 200% FPL, and are ineligible for health coverage through Medi-Cal or Covered CA.

For more information visit http://www.smcchi.org or call Health Coverage Unit: 650-616-2002

San Mateo’s Healthy Kids
Healthy Kids is a low-cost health coverage program for children and teens in San Mateo County. It provides health, dental, and vision coverage for children who do not qualify for no-cost Medi-Cal and Healthy Families. Immigration status does not affect eligibility.
For information and application assistance, call a Community Health Advocate at Health Coverage Unit: 650-616-2002


Contra Costa County:

Basic Health Care (BHC)
Basic Health Care is a county-sponsored health coverage program that provides comprehensive health care services at Contra Costa Regional Medical Center and its Health Centers. Children under the age of 19 may apply regardless of their immigration status.
Who Is Eligible?
•    Families living in Contra Costa County who:
•    meet asset guidelines and income not greater than 300% Federal Poverty Guideline
•    Adults who are a U.S. Citizen or legal permanent resident
•    U.S. citizenship or permanent legal resident not required for children 18 years of age or younger
•    Ineligible for Medi-Cal or any other health insurance
•    Meet assets and real property values within guidelines of the program
For information and application assistance, call Toll Free 1-800-771-4270.

What can I do if I don’t have BHC and need to see a doctor?
You may call a Contra Costa Health Services Financial Counselor at 1-800-771-4270. They can assist you with a referral to one of the community clinics where you may schedule a doctor’s appointment. Please see the list of community clinics (Handout Attached). Please be aware, the community clinic may charge you a fee based on your income.
Contra Costa Health Plan’s Advice Nurse
Contra Costa Health Plan’s Advice Nurse, line is open to everyone; people who call do not need to have proof that they are a Legal Permanent Resident and/or need to be a CCHS patient. The Advice Nurse can give you valuable advice to care for your illness or injury at home. The Advice Nurse will also help you decide if you need emergency or urgent medical care.

To contact an Advice Nurse, please call 1-877-661-6230, option 1


For Counties with Kaiser Permanente:

Kaiser Child Health Plan:
If your county has a Kaiser Permanente, then you may be qualified to purchase Kaiser Health Insurance for your children. Kaiser Permanente’s low-cost program targets families whose children are not eligible for public coverage programs. Families pay a monthly premium between $8 and $15 per child, depending on income. Some services require $5 co-pay. This program provides comprehensive medical, vision and dental coverage. Note: The open enrollment period has ended, but may be qualified for a special enrollment period
For more information and questions about this program, call Kaiser’s Member Services at 1-800-464-4000 (TTY: 1-800-777-1370) or visit Kaiser’s Child Health Plan website: (www.kp.org/childhealthplan)

For Counties not listed: Refer the consumer to their local Social Service agency and/or Community Health Clinic.

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