If you’d like to know how to obtain health care when you’re uninsured or underinsured, this article is for you. We’ll provide you with all the necessary information you need to know so keep on reading to learn more.
Being underinsured or uninsured doesn’t mean that there are not any avenues for getting health coverage. Hospitals that accept the federal money have to provide a specific amount of reduced-fee care or free care. Check with a hospital’s financial aid department in order to find out if you qualify for charity or reduced care.
To begin this process of getting care, first meet with the caseworker at a hospital so you can gather relevant paperwork and start applying for Social Security, Medicaid, and Medicare. Social workers or caseworkers are sometimes assigned by the hospital. If not, you can ask for one. They are there to help you in managing the family member’s care.
Health Insurance Marketplace
The Health Insurance Marketplace is a new way a person can find and receive quality health coverage. It helps those who don’t have coverage or have it but would like to look at some other options. With one Marketplace application, a person is able to review lower costs based on their income, compare their coverage options side-by-side, as well as enroll.
A health reform law requires all American citizens to have an opportunity to shop by phone or online for the best insurance coverage that fits their budget and individual needs. Depending on the person’s income, coverage options provided through Marketplaces can be a much better choice compared to what is currently offered through the individual’s employer, however, they may not always be. Of course, Marketplaces will offer uninsured choices as well.
Depending on where a person lives, a Marketplace in their state will be accessible through the website operated by federal or state governments. Healthcare.gov can quickly direct you to a Marketplace in your own state, so it’s definitely the best place for anyone to get started.
A Marketplace site usually asks you basic questions about where you live, your family size, your income, and then provides an overview of insurance options (both public and private) for which you qualify. However, ultimately, you’ll have to make appropriate decisions based on your budget, your needs, and the needs of your own family.
Medicare is the federal insurance program that is available to those who are:
- 65 years and older (regardless of their income)
- Younger than 65 years with the disability and have received SSDI (Social Security Disability Insurance) for at least twenty-four months
- People of all ages who have an end-stage renal disease, which is a permanent kidney failure that needs dialysis or transplant.
Medicare enrollees cover part of costs through the deductibles for a hospital as well as other costs. Small monthly premiums are also required for the non-hospital coverage. In case you are covered under Medicare, there are some important things you should keep in mind, such as:
- Medicare is not a part of a Health Insurance Marketplace, which means that if you’re already covered by Medicare, then no action is needed.
- According to the CMS (the Centers for Medicare & Medicaid Services), regardless of how a person gets Medicare, whether through a Medicare Advantage or Original Medicare plan, they’ll still have the exact same security and benefits they have now, and they won’t need to make any changes.
- Of course Medicare also has an open enrollment period (October 15 – December 7), during which every person who has Medicare can make some changes to their own health plans as well as prescription drug coverage. If you’d like to know how to make these changes, make sure to call 1-800-MEDICARE or visit medicare.gov.
- The good news is that if you’re on Medicare right now, the ACA will not affect your choices, and all your benefits will not be changing.
However, keep in mind that a Marketplace doesn’t offer Part D prescription drug plans or Medigap (Medicare supplement). If you want to get more information on Medicare and find resources for helping you compare coverage costs and options, enroll in coverage, or check current enrollment, call 1-800-MEDICARE.
Medicaid is the state-based assistance program that serves low-income people who are under the age of sixty-five. Patients don’t usually pay part of the costs for the covered medical expenses, but a small co-payment can still be required. Every state sets its guidelines regarding services and eligibility so you should directly contact the local Medicaid office. Make sure to contact all the relevant benefit offices so you can set up any interviews or appointments needed for expediting the process.
Be aware of any important documentation or deadlines that you may have to provide and also keep accurate records of everybody you’re in contact with. In case you are not sure of your eligibility, the best thing you can do is to apply and have the legal aid office or coworker review the application before submission.
The ACA (Affordable Care Act) provided every state with an option of expanding their Medicaid programs. So far, 39 states have expanded their own programs. For information regarding a Medicaid program in your state, make sure to call the CMS (Centers for Medicare and Medicaid Services) at 1-877-267-2323. You can also visit www.medicaid.gov.
CHIP (Children’s Health Insurance Program)
If the individual is under eighteen years of age, they can qualify for coverage under their own state’s CHIP, which provides health coverage to almost eight million children in those families that have a too high income in order to qualify for Medicaid but cannot afford private coverage.
As for eligibility, it’s determined by every state and is disability as well as income-based. Each state’s SCHIP or CHIP program can have a different name. Keep in mind that your child may still qualify for the SCHIP coverage even if they’re denied Medicaid. Also, children can be eligible for disability benefits from the Supplemental Security Income. Moreover, under the Affordable Care Act, a lot of young adults can remain on the health insurance plan of their parents until age 26.