People without health insurance can get coverage in several ways. These include:
- 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 group insurance 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”, in which they 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
Buying insurance as an individual, rather than as a member of a group, usually results in higher premiums. However, in some cases, these policies can give more options that tailor the 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 that is provided by the federal government to people who are 65 years of age or older, on renal dialysis or permanently disabled. There are two parts to Medicare: Medicare Part A covers hospital costs and some post-hospital care. Medicare Part B covers medical costs, including some equipment, supplies and ambulance transportation. However, Medicare does not provide comprehensive health care. It does not pay for routine annual physicals, experimental treatments, services outside the United States or prescription drugs. Also, people who get Medicare still pay 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).
Medigap
People getting Medicare who need help with these costs or with the cost of services not covered by Medicare can buy private supplemental insurance in the form of a Medigap policy.
There are 10 standard Medigap policies (plans A through J), which vary in coverage. Plan A is the most basic plan. It covers items such as the co-payment amounts for Medicare Part A hospital stays. The plans increase in the amount of coverage, with Plan J being the most comprehensive. Plan J covers such items as preventive medical care, recovery at home and some prescription drugs costs. For more information about Medicare or Medigap policies, call the Medicare Hotline at 1-800-MEDICARE (800-633-4227).
Medicaid
Medicaid is for low-income persons only and is run jointly by the state and federal governments. For this reason, benefits and eligibility vary from state to state. However, in all states, Medicaid eligibility is reviewed every year. Some people who do not qualify for Medicaid at first may end up spending so much of their money during treatment that they become eligible. For more information about Medicaid, call your state's toll-free hotline.
Updated 02/02/09
