US Health Insurance | Learn more about the ACA, COBRA, long-term care, and health care for people with disabilities. You can also discover information on how to find and sign up for health insurance.
Affordable Care Act
The Affordable Care Act (ACA) makes more affordable options for medical, dental, and other types of health insurance available to individuals and families, including those that might not otherwise be available.
Within the ACA:
A state or federal marketplace that offers a variety of policies may let you acquire health insurance.
A pre-existing condition or gender cannot be used by insurers as grounds for denial of coverage. There are neither yearly nor lifetime coverage limits.
Up until age 26, young individuals are still eligible for their family’s insurance.
Seniors who fall into the “donut hole” or coverage gap of the Medicare Prescription Drug Plan are eligible for pharmaceutical discounts.
The end of the year is usually when open enrollment takes place. It’s the time when you’re free to make adjustments to the health insurance you bought using the ACA’s Health Insurance Marketplace.
During the open enrollment period, you will be able to:
- Re-enroll in your current plan
- Choose a plan for the first time
- Choose a new plan to replace your current plan
- Make changes to your existing insurance plan
Typically, changes can only be made year round when:
- Getting married or divorced
- Having a baby or adding a dependent to your family
- Losing other coverage
- Moving to a new state
- Qualifying for Medicaid or CHIP
Read: The Best Rated Insurance Health Company
There are various ways to find out more about and apply for ACA health insurance.
- To apply for coverage through the ACA Health Insurance Marketplace, go to HealthCare.gov; otherwise, a link will take you to the website for the health insurance marketplace in your state. States have different markets, costs, subsidies, programs, and goals.
- The Marketplace Call Center should be contacted.
- Find a local center to apply or ask questions in person.
- To apply by mail, download an application.
Using your Coverage
You must acquire clarification from your insurance provider if you have inquiries concerning particular elements of your insurance plan.
Specific inquiries concerning doctors, prescriptions, treatments, medical equipment, and what is and is not covered by your plan must be directed to your insurance provider.
Health Insurance Plans
Your health insurance may assist you in covering the cost of medical care and prescription medications. Both you and your insurance agree to contribute a specific sum of money or percentage of your medical costs.
How to get Health Coverage
You can get health care coverage through:
- A group coverage plan at your job or your spouse or partner’s job
- Your parents’ insurance plan, if you are under age 26
- A plan you purchase on your own directly from a health insurance company or through the Health Insurance Marketplace
Government programs such as
- Medicare
- Medicaid
- Children’s Health Insurance Program (CHIP)
The Veterans Health Administration or TRICARE for military personnel. Your state, if it provides a health insurance plan.
Continuing employer coverage from your former employer, on a temporary basis under the Consolidated Omnibus Budget Reconciliation Act (COBRA).
Long-Term Care
The phrase “long-term care” (LTC) refers to a range of services, both medical and non-medical, provided to people with disabilities or chronic illnesses. These resources can be useful if you’re considering long-term care requirements for a loved one or yourself:
- Learn the basics of LTC
- Find local long-term care services
- Assess the cost of care
- Learn about legal issues for seniors
Medicare and the majority of health insurance policies significantly restrict or don’t cover long-term care. You could require a separate long-term care insurance policy if you want coverage. You can analyze long-term care insurance plans using the following queries.
What health condition qualifies you for benefits?
You must be unable to carry out some essential everyday duties on your own.
Eating, moving from bed to chair, dressing, bathing, and using the restroom are a few examples.
What kind of medical care is covered?
Does the insurance cover care in nursing homes? Will it cover establishments that offer assisted living but less care than a nursing home? Will it pay for visiting nurses and therapists if you choose to remain in your home? What about assistance with housecleaning and food preparation?
What is the dollar limit on benefits?
The majority of plans offer a fixed daily monetary benefit. The benefit for home care is typically half of the benefit for nursing homes. But some insurance plans offer the same coverage for both types of therapy. Other programs merely pay only for your actual expenses.
What is the benefits period?
A lifetime benefit coverage is available, but it will cost extra. One to six years of coverage is another choice. The typical length of stay in a nursing home is 2.5 years.
Is the benefit inflated for price increases?
The set daily benefit of an insurance purchased prior to age 60 might not be adequate by the time you need it.
Do benefits begin right away?
A waiting period of 20 to 100 days is not unusual.
Health Insurance and Health Resources for People with Disabilities
Find out more about disability-related resources and health insurance.
Health Coverage for People With Disabilities
You have three options for government-sponsored health coverage if you have a disability.
Medicaid: People with disabilities can receive free or inexpensive medical care through Medicaid. Find out who is eligible and how to apply.
Medicare: People under 65 with specific disabilities and those of any age with end-stage renal illness are covered by Medicare for medical expenses (permanent kidney failure requiring dialysis or a kidney transplant). Find out about coverage, eligibility, and how to apply.
People who need health insurance, have a disability, and are not eligible for disability benefits have options thanks to the Affordable Care Act Marketplace. Learn how to enroll in the Marketplace, use your coverage, and more.
Health Resources for People With Disabilities
If you have a disability, federal, state, and local government agencies and programs can assist you with your healthcare needs.
- Visit CDC.gov’s Disability and Health section to get articles, programs, healthy living advice, and more.
- Learn more from the Social Security Administration regarding benefits for those with impairments.
- To find out what medical and health services are offered locally for individuals with disabilities, get in touch with your municipal or county administration.
- You can find medical and health programs by contacting your state’s social welfare organization.
- Learn more about government services and programs that can benefit you and your family by visiting USA.gov’s Government Benefits website.
- If you have a disability, federal, state, and local government agencies and programs can assist you with your healthcare needs.
- Visit CDC.gov’s Disability and Health section to get articles, programs, healthy living advice, and more.
- Learn more from the Social Security Administration regarding benefits for those with impairments.
- To find out what medical and health services are offered locally for individuals with disabilities, get in touch with your municipal or county administration.
You can find medical and health programs by contacting your state’s social welfare organization. Learn more about government services and programs that can benefit you and your family by visiting USA.gov’s Government Benefits website.
