Public health insurance refers to any government funded insurance program. Medicaid health insurance and Medicare health insurance are both government funded programs. You must meet the specific criteria of these plans to be eligible for them.
If you do not qualify for either type of public health insurance you will need to find private health insurance. You can find health insurance plans available in your area by simply entering your ZIP code into the free tool on this page.
If you are denied health insurance from a private company for pre-existing conditions and do not qualify for Medicaid or Medicare you may have other options. You can apply for a federal pre-existing condition insurance plan or for your states insurance pool. Acceptance is not guaranteed though.
What are the qualifications for Medicaid?
Medicaid and Medicare are two different types of public health insurance. They are both funded by the federal government but each one has its own requirements for eligibility.
Medicaid is designed to provide insurance for people who have low or no income. It provides basic health insurance to people who cannot afford to purchase private insurance. You must be considered below the poverty level which is currently set at $14,500 for individuals and $29,700 for families.
In 2014 eligibility will be raised from below the poverty level to anyone below 133%of the poverty level. This means individuals who make less than $19285 and families $39501 will be eligible if the poverty line does not move before then. This change will open Medicaid coverage up to many more people who cannot afford private insurance. You can find the exact eligibility requirements on the Medicaid.gov website.
What are the qualifications for Medicaid?
Medicare insurance is different from Medicaid. It is designed to provide health insurance to individuals with disabilities and people over the age of 65.
You must have paid into the Medicare system during your working years to receive this benefit. Most people pay into this through their employer but if you are self-employed you will need to find what you are required to pay every year. Medicare offers a basic level of care to qualified individuals for free but if you want a higher level of coverage or prescription coverage there will be some out of pocket expense. You can find more details about coverage and eligibility at the Center for Medicare Services.
What is a federal pre-existing condition insurance plan?
When President Obama passed the Affordable Care Act in 2010 it contained provisions for individuals who could not get insurance from private companies because of a medical condition you had prior to applying. You must be a legal resident who has not had insurance for six months and been denied coverage to apply for the federally run pre-existing condition health insurance program.
These plans may be run by your state or the Department of Health and Human Services. Just like with private insurance you will have a monthly premium to pay. These plans are not income based and will charge you premiums based on what you could expect to pay for a private insurance.
With this plan you will receive basic health care plus specialty, hospital, and prescription drug coverage. There are different levels you can purchase based on what you can afford. These levels will determine how much coverage you have and what deductibles you will have to pay for services.
In 2014 the Affordable Care Act states that private insurance companies will no longer be able to deny coverage of pre-existing conditions. At that time the federal government will do away with the pre-existing condition insurance plan.
What is the state insurance pool?
State insurance pools are designed to help people who are denied insurance or given unreasonably high premiums from private companies. They are usually run by non-profit organizations set up by the state. Each state determines how to run their program and eligibility and requirements. You will need to research your state for details on how to apply. It will also help you decide if this is the right option for you.
Unlike the federal pre-existing condition plan you will pay slightly higher than average premiums for this plan. They are capped at 125-200% and most states offer plans at 150% of the cost for a private plan with no pre-existing condition.
Many states impose a waiting period before they will cover any pre-existing coverage. This is to make sure you can pay your premiums and plan on keeping the coverage. For most states the waiting period is usually much lower than what private insurance companies require.
Don’t qualify for public insurance? Search health insurance policies by simply entering your ZIP code into the free finder tool!