Depending on where you are in life, there are multiple options to consider, from multiple sources, to get covered with a plan that works for you.
At its simplest, a private plan refers to any health coverage option that’s offered by an insurance company (as opposed to the government). Some of the names you may recognize are companies like Blue Cross Blue Shield, Humana or UnitedHealthcare.
If you are over the age of 65, under the age of 65 with certain disabilities, or suffer from end- stage renal disease, you may be eligible for coverage through the federal Medicare program.
Medicaid is a jointly funded, federal-state health insurance program for low-income families, pregnant women, children, individuals in need of long-term care, seniors and individuals with disabilities and, in some states, low-income adults ages 18-65, without dependent children.
Medicaid is administered by states in accordance with federal requirements. States establish and administer their own Medicaid programs and determine the type, amount, duration and scope of services within broad federal guidelines. Federal law requires states to provide certain mandatory benefits, and states may also cover other optional benefits.
The Children’s Health Insurance Program (CHIP) provides health coverage to eligible children. In some states, CHIP also covers pregnant women. CHIP is a joint federal-state program that provides low-cost health coverage to children in families that earn too much to qualify for Medicaid, but not enough to buy private insurance
Federal Health Exchange Marketplace
You may be eligible for coverage through the Affordable Care Act (ACA).
These plans are certified by the Health Insurance Marketplace, also known as “the Exchange,” and provide Essential Health Benefits, follow established limits on cost-sharing and meet other requirements under the ACA. All qualified health plans meet ACA requirements for coverage known as “minimum essential coverage.”
Exchanges are also where you can find out if you qualify for exclusive tax credits or subsidies to help offset coverage costs.
- An Advanced Premium Tax Credit is a tax credit that you can use to lower your monthly premium when you enroll in a plan through an Exchange.
- Cost Sharing Reduction is a discount that lowers your cost for deductibles, copayments and coinsurance. On the Exchanges, these are often called “extra savings.”
Depending on the state you live in, you may have your own State Exchange. If not, the Federal Health Exchange Marketplace (healthcare.gov) is your access point for these coverage options.
This is a mouthful, but the Consolidated Omnibus Budget Reconciliation Act (COBRA) is designed to give former employees and their families continued health benefits after the changing or losing of a job or experiencing a reduction in hours. Many employers are required by law to offer COBRA, so be sure to ask if you find yourself in this situation.
Short-term Limited Duration Insurance
This is another option for people who find themselves recently unemployed. These plans bridge gaps in health coverage for a limited duration. The durations allowed will vary by state, often 6 months or up to one year. (Some states also allow them up to 36 months.) Depending on your state, there are different restrictions and limits to coverage. Be aware that these plans are medically underwritten, usually don’t cover pre-existing conditions, and do not offer the same levels of coverage as an ACA plan.
Coverage on another plan
If your spouse or partner has coverage through his/her employer, you may be able to be added to their coverage plan. Their employer or Human Resources department will be able to answer this question. If you’re under 26 years old, you may also be able to stay on the coverage plan of your parents/guardians until you reach 26.