Medicaid and Other Government Health Care Programs


There are several different health insurance options provided by the federal government. Some plans are designed for children, seniors or disabled individuals. Insurance plans also exist just for military members, veterans and their families.

Most types of government health insurance have specific eligibility criteria and are not open to every beneficiary. For example, some programs are just for people with a low income or families with children.

Medicaid

Medicaid insurance is a joint federal and state program for people with a low income. This type of insurance provides medical coverage for free or at a fraction of the cost compared to private insurance plans. Medicaid includes a wide variety of medical services, but states can choose to offer even more coverage.

Children, adults, pregnant women, elderly individuals and people with disabilities can all qualify for this program. Eligibility is based on factors such as an applicant’s age, income and household size. Specific eligibility criteria, such as income limits, can vary from one state to the next.

CHIP

Often combined with Medicaid, the Children’s Health Insurance Program (CHIP) is another type of state and federal insurance that provides free or low-cost coverage to beneficiaries. Children are eligible for this program until they reach 19 years of age. However, in some states, children can keep their coverage for even longer. Under the income limits for CHIP, families can sometimes qualify for this coverage if they earn too much to qualify for Medicaid.

Medicare

Medicare is a government health insurance program for elderly people as well as people with certain disabilities or diseases. This program is generally open to seniors who are 65 years of age or older. Beneficiaries can qualify at a younger age if they have certain disabilities or have diseases such as end-stage renal disease.

Medicare includes four different parts, which allow you to choose the type of coverage that suits your needs. Parts A and B are considered “Original” Medicare. These parts include hospital and medical insurance.  Part C, also known as Medicare Advantage, is a private health insurance option that provides the same Medicare benefits. Part D Medicare can be added to another type of plan if you wish to have prescription drug coverage as well.

Long-Term Care Insurance

If you are elderly or have a medical condition that requires long-term care, you may wish to have long-term care insurance in addition to other types of coverage. Medicare and Medicaid do not cover all types of long-term care, which means you may be responsible for paying for extra services you need. Long-term care insurance can help you afford services that are not medical in nature, such as bathing, dressing, eating or taking medication.

COBRA

Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), you may be eligible to keep getting workplace health insurance coverage for a limited time after your policy ends. COBRA Continuation Coverage can help if you involuntarily lost your job or had your work hour reduced. It is also an option if you lose your coverage because you are transitioning between jobs or you are the beneficiary on a plan that has ended due to death or divorce.

Note that not all types of health insurance plans are covered by COBRA. You need to have an eligible plan in order to benefit from COBRA.

TRICARE

TRICARE is health insurance for active-duty military members, retired military members and their families. Eligibility may be extended to former spouses and survivors as well. This is a comprehensive type of insurance that covers health care, prescriptions and dental services, among other benefits.

You may lose your eligibility if you separate from service or your marital status changes. If you are the child of a military family, you can also age out of your coverage. There are a variety of options that help you transition to a different type of insurance without a gap in coverage.

Veterans Affairs Insurance

The Department of Veterans Affairs (VA) provides insurance for veterans and their families. This type of insurance covers preventative screenings, regular exams, immunizations, inpatient services, mental health services, prescription drugs and more.

Eligibility is based on a veteran’s service record, period of service and other factors. Veterans who meet special criteria may have what is considered an “enhanced” eligibility status. A veteran’s eligibility status can affect when he or she can sign up for coverage, as well as the cost of his or her insurance.

Plans on the Affordable Care Act Marketplace

If you do not qualify for a government insurance plan or work-based insurance, you can still save money by choosing private insurance on the federal health insurance marketplace. There are a variety of ways to qualify for a low-cost plan on the marketplace.