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What is a health insurance program?

three health professionals in health insurance programA health insurance program is a state and federal funded health insurance plan provided to low income adults or children who cannot afford health insurance on their own. Each state has its own programs. Some are specifically designed for uninsured children and others are geared for adults or families with low annual incomes and no employer insurance benefits. Each of these programs has different requirements for consideration.

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What is Medicaid?

Medicaid is one of the most well-known state run health insurance programs. It is designed for low-income individuals of any age, families, or those with disabilities and is funded jointly by the states and the federal government. Currently Medicaid requirements differ by state. However, the recently passed Affordable Care Act will require that by 2014, states allow any individual under age 65 who makes $15,000 annually or less to qualify for Medicaid. Other aspects of Medicaid include:

  • Buy-ins: Some states allow individuals who do not meet the income requirements for Medicaid to pay a small amount toward their premium each month and receive Medicaid benefits.

Individuals with Disabilities:

  • In most states, people with disabilities who receive Social Security Income benefits automatically qualify for Medicaid.

Pregnancy:

  • Women who are pregnant and make $20,000 or less a year will automatically qualify for Medicaid coverage for themselves and their unborn child.

What health insurance programs are available for children?

The federal government now requires states to offer a Children’s Health Insurance Program, or CHIP. These programs typically have different names in each state but similar requirements. Overall, CHIP programs cover children, ages 0 to 19, in families that cannot afford health insurance for their children on their own.

Some examples of CHIP programs include HUSKY in Connecticut and Child Health Plus in New York. Families may or may not have to pay a percentage of the premium each month depending on their income, but this premium payment cannot exceed 5% of that monthly income.

Eligibility for CHIP programs differs slightly from state to state, but some aspects are generally the same in all locations. Typically, families with combined incomes of $45,000 annually or less will qualify. In some states, combined incomes can be higher than this. Pregnant women qualify in order to get prenatal care for their unborn child. Children must be U.S. citizens or legally documented immigrants in order to qualify for CHIP programs.

CHIP Programs cover annual child well visits and immunizations. They also generally cover:

  • Dental care
  • Vision care
  • Hospital care when necessary
  • Lab work and x-rays when necessary

Additional medical services are covered in some states. Parents are also given the option of a co-pay for certain services.

What health insurance programs are available for adults and families?

Several states also offer programs for adults who do not qualify for Medicaid but need help affording health insurance. These programs are typically paid for partially by the state and partially by the individual on a sliding scale depending on their income. They cover preventative care and emergency medical expenses. An example of a program of this type is the Maryland Health Insurance Program or MHIP.

What health insurance programs are available for people with pre-existing conditions?

In 1976, the states of Connecticut and Minnesota introduced the first health care programs to cover people who were considered uninsurable by insurance company standards because of a pre-existing condition. Today, many more states offer programs of this type in order to provide medical benefits, paid for on a sliding scale dependent on income, to individuals that are considered “high-risk.” By providing medical assistance to these individuals, they greatly improve the quality of life for many individuals suffering from debilitating illnesses.

If you are interested in finding out more about state run health insurance programs for those who are uninsured or need help financially, you can visit your state’s health care website for information specific to your location. If you do not meet the qualifications for programs of this type but need information on affordable healthcare, this website is a great place to start.

If you don’t qualify for state run health insurance programs, you can still search for affordable options. Click here and enter your zip code for a list of online health insurance companies and rate quotes.

 

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