The economy has been a source of great anxiety for many of us lately. Healthcare is already out of reach for some 46 million Americans, and with unemployment on the rise, the ranks of the uninsured could grow even larger.
Those with serious financial hardships may be able to get some assistance from Medicaid. A joint state and federal program, Medicaid provides coverage for people with few assets and low income based on the federal poverty guidelines, but eligibility requirements and benefits vary by state. To learn more about your eligibility and how to apply, contact your state health department.
SCHIP (State Children's Health Insurance Program) offers free or low-cost health insurance to children from families who may not be eligible for Medicaid but still have limited incomes. As with Medicaid, states set their own eligibility requirements, but most states cover uninsured children under 19 years old, for a family of four that earns $36, 200 a year or less. Find your state's program to see if your family qualifies. Your state may have other services as well, so contact your local department of social services to find out more.
Keeping health insurance after losing work.
For those facing unemployment and the possibility of losing health insurance, know your options. When you lose your health insurance along with your job, you should receive an offer to continue under your plan for up to 18 months under COBRA or your state's continuation laws (other qualifying events may extend COBRA coverage up to 36 months). You'll have to pay up to 102 percent of the cost of the insurance, including the part previously paid by your employer, so the plans can be very costly, but may be the only option for those with pre-existing conditions. Additionally any pre-existing conditions must be covered by your next employer's plan, as long as your insurance doesn't lapse for more than 63 days.
Those who lose coverage and have existing health conditions that make individual insurance plans hard to find or too costly may look to high-risk pools, which now exist in most states. Costs and benefits of these plans vary greatly from state to state and they are generally more costly than the individual plans available to people in better health. The National Association of State Comprehensive Health Insurance Plans has more information on high-risk pools, including a list of states with these plans and how to contact the appropriate agency. The Kaiser Family Foundation has a wealth of information on these plans, including eligibility requirements. See our full coverage of what to do when you lose insurance for more.
Free and reduced-cost hospital care.
As we mentioned last week, for preventative care and health screenings, you can take advantage of free and low-cost health fairs and clinics that charge only what you can afford.
Hospitals are required by law to provide care in a medical emergency, regardless of your ability to pay. But you can expect to get a bill afterwards that the hospital will aggressively try to collect.
However, some hospitals are actually required to provide free care. Hospitals that received funds to modernize facilities under the Hill-Burton Act of 1946 are obligated to provide a certain amount of free and reduced-cost care. Here is a list of Hill-Burton facilities. You may be eligible for free care if your income is at or below the federal poverty line, currently $21,200 for a family of four, or reduced-cost care at as much as twice that level. Ask the hospital’s admissions or business office for more information on how to apply, and see this Hill-Burton website for more details.
Many non-Hill-Burton hospitals have charity programs as well. These may provide free or discounted care on a sliding scale, with people earning under about 100-200 percent of federal poverty guidelines getting the largest discounts, but some offer assistance to those earning up to four times the poverty level. If you feel you may qualify for such care, ask the hospital about it; hospitals won’t necessarily volunteer their programs' existence.
The Association of American Medical Colleges provides a list of community-based medical programs for the uninsured at medical schools and teaching hospitals around the country. And here is RxAssist's list of free clinic associations.
—Kevin McCarthy, associate editor
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