DENNIS ODA / DODA@STARBULLETIN.COM
Herbert "Hapaki" Robert Franco III adjusts the shirt on his 2-month-old son, Herbert "Herby" Robert Franco IV, as his wife, Codee Franco, holds him and Hapaki's mother, Jackie Franco, looks on. The couple came to Hawaii from Utah to live with Herbert's parents.
The Quest for insurance
A government program turns out to be a godsend for an expecting couple desperately seeking health care
The young couple thought it was too good to be true when told they could have free health insurance for their high-risk pregnancy and child's birth.
"It didn't seem reality," said Codee Franco, 26. "We were shocked to find out it was."
Codee and her husband, Herbert "Hapaki" Robert Franco III, 25, received full coverage through Med-QUEST for her pregnancy and baby, born Aug. 3.
They say it was "a blessing" because they had no money and no other options.
Codee, of Colorado Springs, and Hapaki, of Honolulu, met in California while serving as missionaries for the Church of Jesus Christ of Latter-day Saints.
They ended up at Brigham Young University in Utah after finishing their missions. They married in August 2004 and she became pregnant in December.
"I had a nice case of all-day sickness until the end of February when I finally got it under control," Codee said.
She has two serious medical conditions -- Hashimoto's thyroiditis, a type of autoimmune disease in which the immune system attacks and destroys the thyroid gland, and Addison's disease, which occurs when the adrenal glands do not produce enough of certain hormones that help the body respond to stress.
She was diagnosed with the thyroid disorder three years ago and learned in March, after becoming pregnant, that she has Addison's disease, she said.
DENNIS ODA / DODA@STARBULLETIN.COM
Herbert Robert Franco III and Codee Franco give their 2-month-old son a kiss. The couple benefited from the state's Med-QUEST program, which covered Codee's pregnancy.
"I wasn't doing well in pregnancy. I lost almost 20 pounds. My body was not handling changes well," she said.
She had to drop out of college in February, two months away from graduating, and get a lot of rest because "the baby wasn't growing well. ... The doctor said, 'You can choose your baby or your degree. I'm not sure you can do both.'"
The couple planned to move to Hawaii to be near Hapaki's parents, Jackie and Herbert Franco II of Makakilo.
But they did not know how they would pay their medical bills.
Hapaki said they paid $200 a semester for medical coverage for both of them at BYU, but the fee would have gone to $2,000 with Codee dropping out of school.
He had a job lined up here at the West Oahu Federal Credit Union, but his medical insurance did not cover dependents.
Jackie Franco, Hapaki's mother, said her husband, Herbert Franco II, educational assistant at Puuhale Elementary School, tried to get the baby covered under his insurance.
"But the only way we could do that was to adopt the baby, so that was out of the question," Jackie Franco said.
Jackie, a claims examiner at Schofield Barracks, said a friend there forwarded information to her on Hawaii Covering Kids, and she e-mailed it to her son and asked him to look into it.
Hawaii Covering Kids was established by the Hawaii State Primary Care Association to find uninsured children and sign them up for the state's health insurance programs.
"A lady at Med-QUEST told me if they are under a certain income criteria and going to be living here and pregnant, she would qualify," Jackie said.
"I don't know what we would have done. We were in a panic already when we found out how sick she was and needed special care."
She said she kept up correspondence with Barbara Luksch, Hawaii Covering Kids project director, who was "really, really helpful. She made everything sound easy, which it was, because as soon as they came (to Hawaii) on Wednesday, May 18, they went to apply on Friday and she received everything that day."
Luksch said pregnant women have high priority, and their eligibility for free insurance is determined the same day they go to a Med-QUEST office. Once the mother is covered by QUEST, the baby also is eligible for coverage.
In the Francos' case, Hapaki was unemployed when he arrived, and the Med-QUEST worker realized he also could qualify for QUEST, Luksch said. "A couple weeks later he got sick, so he was grateful he got health insurance."
Luksch said she and Jackie Franco continued to carry on an e-mail conversation, and the proud grandmother sent her pictures after the baby was born.
Codee went to a specialist for high-risk pregnancies at Kapiolani Medical Center for Women & Children and was closely monitored until giving birth to a healthy son Aug. 3, named Herbert "Herby" Robert Franco IV.
The Francos have no idea how much the QUEST program saved them in medical costs. "We haven't seen a bill," Codee said.
"This was a blessing. I believe it came from heaven, from God himself," her husband said.
Both plan to finish studies for their college degrees, Codee in family history and Hapaki in social work and medicine.
Children and pregnant women can enroll
Hawaii Covering Kids is seeking pregnant women and families, and guardians of children and youths to sign up those who qualify for free QUEST and Medicaid health insurance.
The state's Med-QUEST health insurance programs include:
As of last June, 101,000 children were enrolled in free health insurance programs, up from 89,500 in December 2003.
» Medicaid (fee-for-service) for people who are aged, blind and/or disabled. Services are delivered by providers who accept Medicaid.
» QUEST for all others who meet income limits. Health care is delivered through three plans: AlohaCare, Hawaii Medical Service Association and Kaiser Permanente.
The latest number includes 81,500 for QUEST, 2,200 for Medicaid, 14,300 for the Children's Health Insurance Program and 3,000 immigrant children.
Med-QUEST changes in recent years include:
For more information, residents can visit www.coveringkids.com or call 211 at no cost from all islands.
» Expanding programs for children from birth to 19 years of age to include families with household incomes up to 200 percent federal poverty level and allowing benefits for legal permanent residents who have been in the country less than five years. (For example, a family of four earning $44,520 annually can qualify for free medical insurance for their children.)
» Eliminating unnecessary questions in January 2004 on an application for children and pregnant women, such as absent-parent information and a requirement to list assets.
» Starting passive renewals for children on June 1 last year to avoid closing and re-enrolling children because families cannot find documents to fill out forms at renewal time. Parents and guardians review information listed on annual forms from Med-QUEST's computer system, and if there are no changes, they do not have to return the forms. Their children automatically remain in QUEST or Medicaid. Random sample telephone calls and income data checks are done to ensure only eligible children continue to receive benefits.
» Expanded the pregnant-women program on July 1 last year to include legal permanent residents in the country for less than five years.