What health insurance programs are available for aging and/or low-income people?
Medicare is a Federal health insurance program for people 65 years or older, certain people with disabilities, and people with end-stage renal disease (ESRD). When you first enroll in Medicare, you'll have Original Medicare, unless you make another choice. There are different ways you can get Medicare coverage, including a Medicare Advantage Plan (like HMO or PPO). In some types of plans that don't offer drug coverage, you may be able to join a Medicare Prescription Drug Plan.
Visit Medicare.gov to:
- Get detailed information about the Medicare health and prescription drug plans in your area, including what they cost and what services they provide.
- Find doctors or other health care providers and suppliers who participate in Medicare.
- See what Medicare covers, including preventive services.
- Get Medicare appeals information and forms.
- Get information about the quality of care provided by plans, nursing homes, hospitals, home health agencies, and dialysis facilities.
- Look up helpful websites and phone numbers.
For information on Medicare, visit the website or call toll free 1-800-MEDICARE (1-800-633-4227).
Medicare Prescription Drug Coverage: Since January 1, 2006, everyone with Medicare, regardless of income, health status, or prescription drug usage has had access to prescription drug coverage. For more information about this program, visit: http://www.medicare.gov/part-d/index.html.
Medicare offers prescription drug coverage to everyone with Medicare. If you decide not to join a Medicare Prescription Drug Plan (Part D) when you're first eligible, and you don't have other creditable prescription drug coverage, or you don't get Extra Help, you'll likely pay a late enrollment penalty.
To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered.
There are two ways to get drug coverage:
1. A Medicare Prescription Drug Plan (Part D)
2. A Medicare Advantage Plan (Part C), like an HMO or PPO, or other Medicare health plan that offers Medicare prescription drug coverage.
Visit https://www.medicare.gov/drug-coverage-part-d for more information on these two options, or call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
Medicaid is a joint federal and state program that provides free or low-cost health coverage to millions of Americans, including some low-income people, families and children, pregnant women, the elderly, and people with disabilities. The federal government provides a portion of the funding for Medicaid and sets guidelines for the program. Medicaid programs vary from state to state. They may also have different names, like "Medical Assistance" or "Medi-Cal."
Learn More: http://www.medicaid.gov/
The Children's Health Insurance Program (CHIP) is a partnership between the federal and state governments that provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid. In some states, CHIP covers pregnant women. Each state offers CHIP coverage, and works closely with its state Medicaid program. CHIP benefits are different in each state. But all states provide comprehensive coverage, like routine check-ups, immunizations, doctor visits, and prescriptions. Check with your state for information about covered services.
Each state program has its own rules about who qualifies for Medicaid and CHIP. You can apply right now, any time of year, and find out if you qualify. If you apply for Medicaid coverage to your state agency, you'll also find out if your children qualify for CHIP. You must check with the CHIP office in the state you live in to confirm if your family is eligible to get benefits. These programs may be called different names in your state. To find information about the Medicaid and CHIP programs in your state, visit InsureKidsNow.gov or call 1-877-KIDS-NOW (1-877-543-7669). When you call the free and confidential hotline, you'll be connected to someone in your state who can help you learn whether your children may qualify and help you enroll them.
The Health Insurance Marketplace was created by the Affordable Care Act and helps you find health coverage that fits your needs and budget. Every health plan in the Marketplace offers the same set of essential health benefits, including doctor visits, preventive care, hospitalization, prescriptions, and more. You can compare plans based on price, benefits, quality, and other features important to you before you make a choice. People in most states use HealthCare.gov to apply for and enroll in health coverage.
With one application, you'll see if you qualify for free or low-cost coverage through Medicaid or CHIP, or for savings on a Marketplace plan. Most people who apply will qualify for some kind of savings. For more information, visit HealthCare.gov or call the Marketplace Call Center at 1-800-318-2596, 24 hours a day, 7 days a week. TTY users should call 1-855-889-4325.
If your state runs its own Marketplace, you won't use HealthCare.gov. You'll use your state's website to enroll in individual/family or small business health coverage, or both. For a list of State-based Marketplaces, please visit: https://www.healthcare.gov/marketplace-in-your-state/.