People without health insurance can get coverage in several ways, including:
- Buying group insurance through an employer or other organization (such as a union or civic group)
- Buying individual or short-term insurance
- Getting coverage through federal and state programs (such as Medicare and Medicaid)
Group insurance
Although employers are the main source of group insurance coverage, organizations such as unions, professional associations, churches and civic groups may also offer insurance to their members. Because these policies are set for a group of people rather than one person, their premiums tend to be lower.
Many states have programs called “high-risk pools” that sell health insurance to people who have medical conditions and cannot find an insurer at an affordable rate. To find out if your state has a high-risk pool, contact your state insurance commissioner's office.
Individual insurance
When you buy insurance as an individual, rather than as a member of a group, you usually pay higher premiums. However, in some cases, these policies can give more options that tailor benefits to your needs. To find out more about buying individual insurance, contact an insurance agent or broker, your state insurance commissioner's office or your state health department.
Medicare
Medicare is health insurance provided by the federal government to people who are 65 years of age or older, on renal dialysis or permanently disabled.
Medicare Part A and Part B
Basic Medicare has two parts:
- Medicare Part A covers hospital costs and some post-hospital care.
- Medicare Part B covers medical costs, including some equipment, supplies and ambulance transportation.
Medicare does not provide comprehensive health care. It does not pay for routine yearly check-ups, experimental treatments, services outside the United States or prescription drugs.
Medicare plans have co-payments and deductibles. The deductibles on Part A coverage are paid more often than with most health plans (every 60 days instead of every year).
Medicare advantage plans
Medicare Part C (Medicare advantage plan) is run by private insurance companies (such as health maintenance organizations (HMOs) and preferred provider organizations) under contract with Medicare. Medicare Part C includes Part A and Part B, but costs for services vary depending on the plan. Some plans offer prescription drug coverage.
Medicare prescription drug coverage
Medicare Part D (Medicare prescription drug coverage) is run by private insurance companies under contract with Medicare. These plans help cover prescription drug costs.
For more information about Medicare, call the Medicare Hotline at 1-800-MEDICARE (800-633-4227) or visit www.medicare.gov.
Medigap (Medicare supplemental insurance)
A Medigap policy is private supplemental insurance Medigap pays for some Medicare costs (like co-payments) and some services not covered by Medicare Part A and Part B (it fills in “gaps” of Medicare coverage). If you have Medicare Part A and Part B (and do not have a Medicare advantage plan) you can buy a Medigap policy.
There are many Medigap policies with varying coverage. The most basic plan covers items such as the co-payment for Medicare Part A hospital stays. Other Medigap plans cover items such as preventive medical care, recovery at home and some prescription drugs costs.
For more information about Medicare or Medigap, call the Medicare Hotline at 1-800-MEDICARE (800-633-4227) or visit www.medicare.gov.
Medicaid
Medicaid provides health care to low-income persons. This program is run jointly by the federal and state governments, so benefits and eligibility vary from state to state.
You also may be eligible for Medicaid (even when your income level is too high to qualify) if you have very high medical expenses. For more information about Medicaid, call your state's toll-free hotline.
Updated 01/25/11
