If you are aging and/or low-income, several health coverage programs may be available to you. Medicare, Medicaid, and the Affordable Care Act (ACA) are some of the most well-known programs, but there are others. This comprehensive guide will discuss these health insurance programs in detail and help you figure out which one is right for you!
What is Health Insurance?
This is a type of coverage that covers the medical and surgical expenses of the insured. It reimburses the insured for expenses incurred from illness or injury or pays the care provider directly. It can be purchased as an individual or group plan.
Medicaid insurance for your healthcare is provided by the U.S. government and by various state governments around the country. This program provides health insurance for low-income individuals. This free health insurance is available to many low-income citizens. Although it is a federal program, whether or not you qualify will be determined by your state guidelines.
Medicaid is a no cost health insurance program designed to help children, senior citizens and people who have a physical handicap. This state sponsored medical insurance is also available to low-income individuals who are in need of health insurance. As a result, these individuals can receive health insurance benefits if they qualify for this type of assistance.
Best Health Insurance Plans for Retirees and Seniors
Retirees and seniors can choose from a variety of health coverage policies. Your needs and finances will determine your ideal health coverage plan. Four types of health coverage plans are provided to the elderly and/or low-income persons, including Medicaid, Medicare, CHIP, and COBRA.
Medicaid is a government-subsidized healthcare program for low-income adults, children, pregnant women, and persons with disabilities. It is funded jointly by the federal government and the states.
Federal Poverty Level thresholds to qualify for Medicaid
Your income must be below a particular threshold to be eligible for Medicaid. This is known as the federal poverty level (FPL). Each state’s FPL is different. The FPL for a single individual in 2020 was $12,760. This means that if your annual income is less than $12,760, you may be eligible for Medicaid.
If your income exceeds the FPL, you may still be eligible for Medicaid if your state’s Medicaid program has been expanded. Thirty-six states have expanded their Medicaid programs as of 2020. Adults with incomes up to 138% of the FPL are eligible for Medicaid in these states.
What States Provide Medicaid Insurance?
Once again, the federal government offers Medicaid insurance. All states and the District of Columbia currently provide this health insurance coverage. Subsequently, each state has their own rules for who qualifies and how to file. You can check with your county services to see what the guidelines are for your state. This will help you determine if you qualify for Medicaid and what services you may receive.
SSI and SSA and How They Apply to Medicaid
SSI and SSA are the letters that stand for Supplemental Security Income and Social Security Administration. The application process for these are often used for the Medicaid process as well.
People who qualify for SSI and SSA are typically eligible for Medicaid. Most receive Medicaid insurance benefits when they start to obtain their SSI and SSA payments. Check with your local or county services to make sure you are receiving all the benefits you are entitled to.
General Medicaid Insurance Requirements
Those who have an income that is below 100 percent of the federal poverty guideline are usually eligible for Medicaid. Federal and state governments have income guidelines that they use for various programs. These guidelines are based on your adjusted gross income. In other words, there are monthly income limits depending on the size of your family.
However, since these limits receive frequent updates, please make sure to check what the limits are for your state currently. Just because you didn’t qualify once doesn’t mean you will never qualify. Circumstances change, and unlike Marketplace coverage, you can apply for Medicaid insurance any time of year.
Non-Financial Eligibility Requirements
Other requirements for Medicaid insurance include being a U.S. citizen and a resident of the state where you are applying. Certain kinds of qualified non-citizens can also receive this benefit. States have their own rules for this situation. In addition, all pregnant women who do not have health insurance should apply.
Information About Coverage
Qualified Medicaid applicants will receive coverage on the date of their application or on the first day of the month of the application. In fact, applicants can receive coverage for up to 3 months prior to the month of application. This simply means that if a person has medical bills 3 months prior to applying, Medicaid will pay these bills. However, current applicants can be disqualified if they are no longer eligible.
Medically Needy Qualifications
Some U.S. citizens who have severe medical problems can also receive this benefit. If a person with severe medical issues has a low income that meets the standard requirement; they will usually receive coverage. As a result, extra medical related expenses that a person incurs during illness will be covered.
How Does Medicaid Work?
Medicaid insurance provides the same service as Medicare. However, Medicaid covers some things that Medicare does not. Recipients can also get premiums, co-payments covered. Some Medicaid applicants can also receive care for long-term nursing assistance.
Medical Benefits Provided by Medicaid Insurance
Medicaid insurance provides two types of benefits. One type is for standard benefits and the other is for optional benefits. Standard coverage is for inpatient hospital services, outpatient hospital service and services for nursing and home health aides. Optional benefits are for prescription drugs, physical services and clinic services. Medicaid also covers eyeglasses, dentures and dental services. Additionally, occupational therapy, rural health care and midwife services are covered. These services and many more are provided as needed by Medicaid.
Medicaid Insurance Payment Amounts
A person’s Medicaid payment coverage will vary by individual and by the amount that they have been awarded. Medicaid insurance payments are to be used for medical related services and nothing else. Also, payments can vary if a there is a change to their medical situation.
Medicaid.gov provides more information about this form of health coverage. If a person does not live within a state that offers this service, try looking into federal Medicaid assistance. The Medicaid.gov website will describe everything a person needs to know about this service.
What Is Medicare?
Medicare is a federal health coverage program for people 65 years or older or with certain disabilities. It has four parts: Part A, Part B, Part C, and Part D. • Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and home health care. • Part B covers outpatient medical services, including doctor visits, preventive screenings, and durable medical equipment. • Part C is also known as Medicare Advantage.
It is a private coverage plan that covers all of the benefits of Part A and Part B. Extra benefits, like dental and vision care, may be included in Medicare Advantage plans. • Part D covers prescription drugs. It pays for the cost of prescription medications.
You can obtain Medicare through a private insurance provider or enroll in Original Medicare (Parts A and B). You can add a Part D prescription medication plan or join a Medicare Advantage Plan if you have Original Medicare.
The Children’s Health Insurance Program (CHIP)
The Children’s Health Insurance Program (CHIP) is a federal-state collaboration that offers health coverage to low-income children who do not qualify for Medicaid. It covers doctor visits, preventive care, prescriptions, dental care, vision care, and more.
To be eligible for CHIP, a child must be under 19 years old and have an income below the CHIP program’s limit. In 2020, the CHIP program’s income limit was $51,040 for a family of four.
Consolidated Omnibus Budget Reconciliation Act (COBRA)
Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal law that allows you to keep your employer-sponsored health coverage for a limited time after you leave your job. It allows you to remain on your employer’s health coverage plan for 18 to 36 months, depending on your circumstances.
You must pay the full payment plus a minor administrative fee. To be eligible for COBRA, you must have had employer-sponsored health coverage when you were working. You also must have left your job voluntarily or been fired for reasons other than misconduct.
The Affordable Care Act (ACA)
The Affordable Care Act (ACA) is a law that requires all Americans to have health coverage. It also includes subsidies to assist consumers in paying for health coverage. If you do not have health coverage through your employer, Medicare, Medicaid, CHIP, COBRA, or another source, you can purchase one through the Health Insurance Marketplace.
This website allows you to compare several health coverage plans and select the one best for you. You can also find out if you are eligible for a health coverage subsidy.
How to Find Affordable Coverage
- Many health coverage programs are available. However, finding affordable coverage can be a challenge. Here are a few tips to help you find the coverage you need:
- Talk to your doctor or other healthcare providers about your options. They may be able to recommend a program that fits your needs.
- Look into government programs such as Medicaid or the Children’s Health Insurance Program (CHIP). You may be eligible for coverage through one of these programs.
- Check with your state or local health department to see if they offer coverage programs. •
- Contact your local social services office to see if they can help you find affordable coverage.