Do I Qualify For Health Insurance?

Whether you have been uninsured for a long time or have recently become uninsured, there are multiple options for you to gain access to health insurance.

Despite your current or past health condition, it is in your best interest to obtain health insurance coverage if at all possible. Insurance coverage provides easier access to care and you will have more doctors to choose from since many doctors do not treat uninsured patients. In addition, insurance gives you and your family protection against a future unexpected health crisis which could potentially leave you struggling with an exorbitant amount of medical debt.

All health insurance plans must cover preventive services and common screenings that may help you identify medical concerns as early as possible, giving you more options for treatment and care. Gaining coverage with a health plan that includes dependents and household members ensures they are protected as well.

These questions can help you identify if you qualify for various types of insurance or health benefits.

Have you been deemed disabled by the Social Security Administration?

If you answered “Yes”.

  • You may qualify for Medicaid through your state.
  • If you do not qualify for Medicaid, you will become Medicare eligible once you have received Social Security benefits for 29 months or have turned 65.
  •  If you have recently stopped working, were deemed disabled, and elected COBRA benefits, you may be eligible for an 11 month extension of COBRA in order to bridge the gap between the normal 18 month COBRA period and the waiting period for Medicare.

Are you married?

  • “Yes”, if you are married at the time you become disabled and your spouse has an employer group health policy, you may be eligible to elect coverage under your spouse’s policy, and may no longer be denied coverage or excluded benefits as a result of a pre-existing condition.

Does your employer offer group benefits?

  • If “yes”, you may choose to elect group health insurance benefits upon being hired or during open enrollment periods
  • If “no”, you may purchase a plan through your state or federally run Health Insurance Exchange.

Are you under 26 years old?

  • Healthcare regulations allow parents to cover children under their policy until the age of 26 years old, regardless of student status, employment or medical history.

Did you recently lose a job that provided health insurance benefits to you?

  • If you answered “yes”, you may be eligible for COBRA benefits.

Did you exhaust your COBRA benefits?

  • If you answered “yes”, you may be HIPAA eligible plan.
  • If you have had 18 month of continuous coverage and have exhausted your COBRA benefits not due to fraud or nonpayment of premiums, you have 63 days from the date your COBRA benefits term to elect a HIPAA eligible plan.

Consider purchasing a plan through your State Health Insurance Marketplace. Marketplaces will also screen you for medicaid eligibility and connect you to that program if you are meet the criteria. Depending on your income and household size, you may qualify for financial assistance and lower costs for your insurance purchased through the marketplace. Submit the enrollment application for processing as soon as possible for the earliest effective date of coverage.

For more specific questions pertaining to health insurance options in your area, contact your state’s Bureau of Insurance.

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