LOW INCOME? NO HEALTH INSURANCE? APPLY FOR MEDICAID
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Medicaid is a joint federal and state program that:
- Helps with medical costs for individuals with limited income and resources
- Offers benefits not normally covered by Medicare, like nursing home care and personal care services
How to apply for Medicaid
Each state has different rules about eligibility and applying for Medicaid. Click here for state Medicaid program contact information to see if you qualify and learn how to apply.
Medicaid spend down
Even if you have too much income to qualify, some states let you “spend down” to become eligible for Medicaid. The “spend down” process lets you subtract your medical expenses from your income to become eligible for Medicaid. In this case, you’re eligible for Medicaid because you’re considered “medically needy.”
To be eligible as “medically needy,” your measurable resources must also be under the resource amount allowed in your state. Call your state Medicaid program to see if you qualify and learn how to apply.
If you have Medicare and full Medicaid coverage, most of your health care costs are likely covered.
You can get your Medicare coverage through Original Medicare or a Medicare Advantage Plan (Part C). If you have Medicare and full Medicaid, you’ll get your Part D prescription drugs through Medicare. And, you’ll automatically qualify for Extra Help paying for your Medicare prescription drug coverage (Part D). Medicaid may still cover some drugs and other care that Medicare doesn’t cover.
Visit https://www.medicare.gov/ for more information on Medicaid (and Medicare)
APPLYING OR RENEWING INSURANCE THROUGH HEALTHCARE INSURANCE MARKETPLACE
Visit https://www.healthcare.gov/ to enroll
IMPORTANT DATES TO KEEP IN MIND
- November 1, 2019: Open Enrollment started — first day to enroll, re-enroll, or change a 2020 insurance plan through the Health Insurance Marketplace.
- December 15, 2019: Last day to enroll in or change plans for 2020 coverage. After this date, you can enroll in or change plans only if you qualify for a Special Enrollment Period.
- January 1, 2020: 2020 coverage starts, if you’ve paid your first premium.
If you haven’t applied for insurance on HealthCare.gov before, here’s what you need to know about the Health Insurance Marketplace (sometimes known as the health insurance “exchange”).
Click here for quick guide
Still need health coverage for 2019?
Open Enrollment for 2019 plans is over. Open Enrollment for 2020 runs Friday, November 1 to Sunday, December 15, 2019. Coverage starts January 1, 2020.
If you still want coverage for the rest of 2019:
- See if you qualify for a Special Enrollment Period due to a life event like losing other coverage, getting married, or having a baby.
- See if you qualify for Medicaid or the Children’s Health Insurance Program (CHIP). You can apply for these programs any time.
SEE IF YOU CAN STILL GET 2019 COVERAGE
1. 2020 Open Enrollment runs from November 1 through December 15, 2019
- Plans sold during Open Enrollment start January 1, 2020.
- After December 15, you can enroll in 2020 health insurance only if you qualify for a Special Enrollment Period.
2. The Health Insurance Marketplace is for people who don’t have health coverage
If you don’t have health insurance through a job, Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), or another source that provides qualifying health coverage, the Marketplace can help you get covered.
- If you have job-based insurance: You can buy a plan through the Marketplace, but you’ll pay full price unless your employer’s insurance doesn’t meet certain standards. Most job-based plans do meet the standards.
- If you have Medicare: You can’t switch to Marketplace insurance, supplement your coverage with a Marketplace plan, or buy a Marketplace dental plan. Learn about Medicare and the Marketplace.
3. What you pay for insurance depends on your income
Your savings depend on your expected household income for the year.
Get a quick idea if you’ll save. Based on your income estimate, we’ll tell you if you qualify for:
A health insurance plan with savings based on your income
- You may qualify for a premium tax credit that lowers your monthly insurance bill, and for extra savings on out-of-pocket costs like deductibles and copayments.
- The plans are offered by private insurance companies with a range of prices and features.
Medicaid or the Children’s Health Insurance Program (CHIP)
- Many states are expanding Medicaid to cover all households below certain incomes. See if your state is expanding and if your income is in range to qualify.
- Your children may qualify for CHIP even if you don’t qualify for Medicaid.
- You can apply for coverage several ways
Starting November 1, you can apply any way that works for you:
- By phone
- With in-person help
- Through an agent or broker
- Through certified enrollment partner websites
- With a paper application
65 YEARS OLD OR OLDER? NO HEALTH INSURANCE? APPLY FOR MEDICARE
VISIT https://www.medicare.gov/ for application and more information
Expanded Medicare benefits for preventive care, drug coverage
- Medicare benefits have expanded under the health care law – things like free preventive benefits, cancer screenings, and an annual wellness visit.
- You can also save money if you’re in the prescription drug “donut hole” with discounts on brand-name prescription drugs.
More Medicare details
- Medicare’s annual Open Enrollment Period (October 15-December 7) hasn’t changed.
- To learn more about your Medicare coverage and choices, visit gov.