Health Insurance Options For Grant Seekers
Health insurance is important. It's required by the Affordable Care Act (ACA), which imposes significant financial penalties on Americans who fail to secure insurance. It's also necessary: Medical debt is America's leading cause of bankruptcy.
Soaring medical costs have made it almost impossible for an uninsured American to get through a medical event without major financial repercussions.
Free and low-cost health insurance is available to families and individuals with limited income. These plans might not be "grants" according to a strict definition because they don't involve giving out money, but they provide real discounts on vital services. Because insurance plans are offered and managed at the state level, you will need to investigate what's available in your state, but some programs are available in all 50 states. One goal of the Affordable Care Act (ACA) was to provide a means for insurance companies to compete for business. This open competition drives prices down. The ACA also gives consumers the freedom to choose a plan based on their individual needs and preferences. Merging these and other goals into statewide healthcare exchanges gives consumers anywhere from four to over one hundred options. Understanding the system can help you know what steps to take.
Navigating The Jargon
is available nationwide. It is a free or low-cost social program that provides health care for individuals and families with low income. The income level required for eligibility varies from state to state. You will need to check the exact level for your state first. Many self-employed and full-time employed individuals and families have incomes that qualify them to receive benefits under Medicaid.
is available in 31 states plus the District of Columbia. 19 states do not have expanded Medicaid. Louisiana has not yet ruled. Under expanded Medicaid, families may earn up to 133% or higher of the poverty line for their state and still be eligible for Medicaid.
Children's Health Insurance Program (CHIP)
provides low-cost health coverage for children in families who earn too much to qualify for Medicaid. Each state has a program, but CHIP and Medicaid coordinate on coverage across the country.
The Affordable Care Act
is the federal statute that establishes current standards. This law, sometimes known as "Obamacare," regulates who must have health insurance, what insurance plans must provide, and who is eligible for federMedical Bills Are the Biggest Cause of US Bankruptcies: Studyal subsidies. Obamacare and the Affordable Care Act are the same thing.
A Health Insurance Marketplace
is a state market where you can purchase a government-regulated health care plan. Government subsidies are available only through the marketplace. If you are uninsured and eligible for a subsidy, you must purchase your insurance through the marketplace to receive the subsidy.
is another term for the Health Insurance Marketplace. Again, these are two names for the same thing.
is a period that typically falls between late fall and late January. During the Open Enrollment window, individuals and families may sign up for Obamacare and receive the best discounts. Outside of open enrollment months, you may qualify for short-term insurance or may enroll with a Qualifying Life Event. Medicaid is always open and does not require a Qualifying Life Event for enrollment.
includes months outside the open enrollment period. During special enrollment, you can enroll in Obamacare without penalty if you have a Qualifying Life Event.
A Qualifying Life Event
is a designated situation that exempts you from the open enrollment period. The most common events are a loss of coverage; marriage; new child in the home either through birth, adoption, or foster care; moving to a different state; or a change in household income.
Understanding the Process
Your eligibility for free or low-cost health care programs and discounts is determined by where you fall within state guidelines based on your income and household size. On nearly all healthcare websites, the first information you are asked to provide is your zip code. From your zip code, you will be directed to plans available in your state.
Medicaid, CHIP, or Marketplace? Depending on your income and household size, you may be directed to Medicaid or the Marketplace. Even if you are sent to the marketplace, look up the Medicaid standards for your state. If your annual income falls below the line set by your state either under Medicaid, Expanded Medicaid, or CHIP you may apply for Medicaid. It is not necessary for you to enter the Health Care Marketplace and choose coverage if you are eligible for Medicaid.
If you make too much for Medicaid, you may still qualify for a federal subsidy toward your monthly payments. The Health Care Marketplace automatically calculates your subsidy. 8 of 10 uninsured individuals are eligible for some subsidy in the Marketplace.
Finding The Right Coverage For You
Is your doctor in the plan? If you prefer a particular doctor, you will need to choose a plan where that doctor participates. Also consider the hospitals, labs, and other facilities included. You will want to choose a plan that has quality facilities and providers in convenient locations.
What percentage of which prescriptions does the plan cover? Prescription costs can add up quickly. Choose a plan that covers medications you currently take or are likely to use in the coming year.
What is the real cost? The total cost of your care is much more than the monthly premium. Depending on the plan you choose, you will need to pay a deductible which could be several thousand dollars. Also, you may be responsible for copays on doctor visits or for a percentage of all services you receive.
If you don't fully understand the plans, don't feel bad. The jargon can be intimidating and few people really understand it. If you have questions, ask. Insurance company customer service representatives are professional, responsible, helpful sources of information. They can get you through the chaos and find the plan that fits your needs.
Many of us have a variety of immediate needs. Perhaps health insurance is not on the same level as food or clothes, but when you're sick, have an unexpected accident or are diagnosed with a disease, it moves directly to the top of the list. Learning about insurance may not be an exciting way to spend a Saturday afternoon, but understanding and reviewing your options is time well spent. Making the right choices can give you and your family peace of mind without adding another significant expense to your budget, and that's as good as a straight gift of cash!