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When can you buy government health insurance?

Keep in mind...
  • There are several types of government health insurance, each with their own qualifications
  • If you are over 65, you can apply for Medicare
  • Children may be covered under the CHIP program, while low-income individuals may be eligible for Medicaid coverage
  • Everyone is required to have health insurance under the Individual Mandate enacted by the Affordable Care Act

Government insurance has been available in the United States since 1965. But unlike other health care models around the world, government insurance is only available to some.

You can only get government insurance if you fall under certain circumstances, such as income, disability, or age. If you or your family are able to get government insurance, you can either get it at a very low cost or no cost at all. But before you look into this possibility, here’s what you need to know:

  • Have no employer-provided coverage. This means your employer does not provide you and your family with health insurance.
  • Discontinue COBRA coverage. This means no longer continuing with your employer-provided coverage if you’ve been laid-off.
  • Do not qualify for insurance under Obamacare. This means if you don’t qualify in purchasing insurance purchase from your state’s marketplace.
  • Qualify for Medicaid. This means you qualify for government health insurance available if you or your household are in a lower income bracket.
  • CHIP. This is the government’s health insurance plan for children.
  • Qualify for Medicare. This means getting the government health insurance available for those over 65 years old or for those who have certain conditions.

Enter your zip code above to receive free health insurance quotes from your state’s best providers.

Have no Employer-Provided Coverage

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If your employer provides coverage for you and your family, then you can’t qualify for government health insurance. But there are exceptions to this.

For example, if your household income is low enough, you may qualify for government health insurance. Also, if you’re over 65 years, you can also qualify for government insurance.

Discontinue COBRA Coverage

If you have an existing COBRA plan, it may affect your eligibility to get government insurance. You can get government insurance if you’re unable to continue with the COBRA plan or if you turn 65 this year.

For more information about this, please go to the next steps when unemployed at Healthcare.gov.

Do Not Qualify for Insurance Under Obamacare

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If you’re able to purchase health insurance from your state’s marketplace, which is also known as Obamacare, then you won’t be able to qualify for government coverage. To find if you qualify for Obamacare, go to Healthcare.gov and select Get Coverage. Select your state and it will either say, ”VISIT YOUR STATE MARKETPLACE” or it will say ”CONTINUE.”

If it says, “VISIT YOUR STATE MARKETPLACE”, then your state has a health insurance marketplace. If it says ”CONTINUE,” then you would buy your insurance from the marketplace created by the federal government.

If your household income is too low to purchase anything from the marketplace or if you’re turning 65, then you can qualify for government health insurance, such as Medicare, Medicaid, and CHIP.

Qualify for Medicaid

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Medicaid is the health insurance program for those who have lower incomes, pregnant women, children, families, people with disabilities, and the elderly. Depending on your household income, you can either get Medicaid at a low-cost or no cost at all.

Also, other factors, such as household size and disabilities, can affect whether you can get Medicaid at a low-cost or no cost at all.

For more information about Medicaid, please check Medicaid.gov.

CHIP

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Children’s Health Insurance Program (CHIP) is the government health insurance you can get for your children. Depending on your income, you can either pay a low cost or get it at no cost. If you do need to pay monthly premiums, the cost won’t exceed more than 5% of your family’s yearly income.

To apply for CHIP, you can either call 1-800-318-2596 (TTY: 1-855-889-4325) or fill out an application through the health insurance marketplace.

CHIP covers the following:

  • Routine check-ups
  • Immunizations
  • Doctor visits
  • Prescriptions
  • Dental and vision care
  • Inpatient and outpatient hospital care
  • Laboratory and X-ray services
  • Emergency services

Some states’ CHIP program might offer more than this. Check your state for details.

For more information about CHIP, please check Medicaid.gov.

Qualify for Medicare

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Medicare is the government insurance for those 65 years and older. But Medicare can be available to those under 65 if you have certain disabilities and if you have End-Stage Renal Disease (ESRD). There are some parts of Medicare you would need to know:

  • Part A
  • Part B
  • Part C
  • Part D

Part A is when you have hospital insurance. This covers services such as skill nursing facilities, inpatient hospital care, critical access hospitals, and some home health care. Typically, you do not pay for this service because it has been paid for already through payroll taxes.

Part B is when you have medical insurance. This covers services such as outpatient care, doctor visits, occupational therapy, and some home health care. It also covers for service that Part A doesn’t cover.

Part C is when a private insurance company with Medicare to provide you a health plan. This part includes the services that covered in Part A and B.

Part D is when you have prescription drug coverage. You can either get coverage from the Medicare program or from a private insurance company. Typically, you pay a monthly premium for this part of Medicare.

For more information about Medicare, go to Medicare.gov.

Knowing these things can help determine when or if you can get government insurance for you and your household. If you need care and you can’t afford the insurance plans out there, including your employer’s, then getting government insurance is a way to go.

For more information about government insurance, please visit Healthcare.gov and CMS.gov.

You can also enter your zip code on this page to receive free, customized health insurance quotes for you and your whole family to ensure all your options are explored.

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