Some financial assistance programs help low-income individuals and families get affordable health care. The federal government operates the following national health care programs:
Eligibility for each of these programs varies slightly depending on your state, age, income and other personal factors. While you will not receive financial help in the form of cash assistance, you could receive free or low-cost health insurance to receive essential, comprehensive medical coverage.
Medicaid insurance provides health coverage to millions of low-income adults, children, elderly adults, pregnant women and disabled individuals. Medicaid is a joint state and federal program, and it operates individually in each state. This means that states have the ability to define how they issue Medicaid coverage.
Medicaid eligibility varies in each state. However, there are certain mandatory coverage groups defined by the federal government that must qualify in each state, regardless of any state-specific rules. These are:
- Low-income families
- Qualified pregnant women
- Qualified children
- Recipients of Supplemental Security Income (SSI)
Those with Medicaid eligibility must have household incomes at or below their state’s income limits. Some states have expanded Medicaid, which means you can qualify for the program based on your income alone. In states that have Medicaid expansion, you can qualify if your income is below 133% of the federal poverty level (FPL).
Medicaid covers a variety of medical services for both adults and children. Medicaid dental coverage is automatically available for all children. However, many states do not include Medicaid dental coverage for adults beyond emergency dental services.
If you qualify for Medicaid insurance, the amount you must pay for insurance varies depending on your state. You may need to pay monthly premiums (the cost of having insurance) or copayments (the cost for receiving a service).
CHIP, or the Children’s Health Insurance Plan, provides health coverage to children through both the Medicaid program and separate CHIP programs.
Uninsured children can qualify for financial help through CHIP if their families have incomes too high for Medicaid but too low to afford private coverage. In addition to meeting income requirements, children must meet the following criteria:
- Be younger than 19
- Be uninsured
- Be a citizen or meet immigration requirements
- Be state residents
Some states extend CHIP coverage to pregnant women and cover them for prenatal, delivery, and postpartum care. Furthermore, states with this option must extend coverage to infants born to qualified pregnant women until they reach 1 year of age.
The cost of CHIP coverage varies. States that have expanded Medicaid follow the same rules for cost sharing within the CHIP program. States that operate CHIP as a separate program set their own cost-sharing rules and requirements.
You can apply with the Medicaid office in your state for both CHIP and Medicaid.