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Even before the Affordable Care Act mandate that every American must have health insurance coverage, going without health insurance was extremely risky. All it takes is one broken bone to accrue tens of thousands in medical bills. If you suddenly lose your healthcare plan because you lost your job or simply aren’t in a position financially to pay the premium it can be an unsettling situation.

There are hardship exemptions that allow an individual to get a waiver for the health insurance mandate, but you’d still have to go without coverage. When you’re unable to get health insurance through an employer or on your own there are state and federal programs that can help.

State Medicaid System

Medicaid is a health insurance program that’s jointly funded and managed by the federal and state governments. The program is designed to offer assistance to low-income adults and their children.

In general, Medicaid eligibility is based on financial need, however each state operates their own Medicaid system. That means the specific regulations and requirements vary from state-to-state. For example, California’s Medicaid system (Medi-Cal) offers a number of Medicaid programs. Medi-Cal eligibility is based on the program a person is trying to join.

In order to receive free or low-cost health insurance through Medicaid you must complete the enrollment process. This process will depend on the state you live in, however, you should be able to initiate the process online, over the phone or in person at a county Medicaid office. You can also learn how to apply at the federal Medicaid website.

COBRA

Many Americans get their health insurance by joining a group plan through their employer. In those cases, when a person loses their job they lose both their income and their healthcare coverage. The government has stepped in to create a program that will ease some of the burden by allowing you to stay on the group plan.

The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows workers as well as their spouses and dependents to keep their health care coverage for up to 36 months after being let go. This temporary extension is called continuation coverage, and is generally required when an employer group plan includes 20+ people.

You may also be eligible for COBRA under other circumstances (qualifying events), including:

  • Voluntarily having to leave your job
  • Reduction in the hours worked
  • Transition between jobs
  • Death
  • Divorce

In addition to having a qualifying event and meeting the eligibility requirements, your employer’s group plan must be covered by COBRA. Your COBRA rights will be outlined in the health insurance Summary Plan Description (SPD), which must be given to the policyholder within 90 days of receiving coverage. The SPD will also specify if the employer or employee is responsible for notifying the insurance company when a qualifying event occurs.

Once the insurance company is notified about the qualifying event they will send a COBRA election notice. You’ll have up to 60 days to choose whether or not you want to receive COBRA continuation coverage. In most cases you will have to pay for the entirety of the plan for it to stay active.

Children’s Health Insurance Program (CHIP)

If you have children and are unable to pay for their health insurance the Children’s Health Insurance Program (CHIP) can help. CHIP programs are run by each state. Like Medicaid, the eligibility and requirements vary from state to state.

To find out about the CHIP enrollment process and eligibility in your state call 1-877-543-7669 or visit InsureKidsNow.gov.

Medicare

Medicare is a federal health insurance program for the elderly and some younger individuals with certain disabilities. If a person is 65 or older they are eligible for Medicare coverage free of charge regardless of income or financial need.

There are four parts to Medicare that cover various services:

  • Medicare Part A – hospital coverage
  • Medicare Part B – medical insurance
  • Medicare Part C – Medicare Advantage Plan
  • Medicare Part D – prescription medication coverage

A Medicare Advantage Plan refers to a Medicare health plan that’s provided through a private company and covers the services included in Part A and Part B.

 

About the author: admin

 

TMB is the founder of Repaid.org. He has paid down 90% of his credit card debt through smart budgeting, frugal-living, and inspiration/support from other personal finance bloggers.

 

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