Your Guide to Federal Healthcare Options

On the grand scale of things, having good health should always be our top priority. We can spend the rest of our lives chasing money, cars, houses, etc. If we’re not feeling healthy, there’s little to no chance that we’d enjoy any of it. Unfortunately, in America, getting our health taken care of can cost a pretty penny. Sometimes, it’s almost unbelievable that almost 80 million Americans have healthcare-related debts. That means that almost 1 out of every 4 Americans is in debt for taking care of their health. Considering that America is one of the richest countries in the world, the whole healthcare debt thing is just insane.

Thankfully though, the government is well-aware of the issue. The topic has been the center of many political and media discussions. That’s why the government creates federal assistance programs. The idea is to try and make healthcare more accessible to Americans. Each federal healthcare assistance program aims to serve a certain group of Americans. Some of these programs are based on age, others are based on income. The trick is to know which program you qualify for. You might qualify for more than one program at a time. You should also know what exact steps you should take to apply for these programs. In this article, we want to give you all that necessary information. But, remember that governmental websites will always be your most reliable source for information on these programs.

The Types Of Federal Healthcare Options You Can Find

The government creates federal assistance programs to help out Americans in need. These programs often focus on Americans who need them the most. Whether it’s someone who doesn’t have enough income to meet their needs,  or someone with a disability that challenges their ability to increase their income or make any income at all. Applicants must know what kind of programs are available to them, and more importantly, which ones they qualify for. The government created a neat webpage where you can learn about almost all federal assistance programs. That page will not only list the kind of federal assistance programs available, including healthcare ones but will also help you narrow down the ones you’re eligible for.

Children’s Health Insurance Program (CHIP)

The government, through the CHIP program, tries to help American families. Eligible families can get access to affordable healthcare through this program. CHIP aims to provide comprehensive healthcare coverage, including routine check-ups, immunizations, doctor visits, prescriptions, dental/vision care, scans, tests, and emergency services. CHIP may provide healthcare coverage for kids, but in some cases, the coverage may extend itself to pregnant women as well.

“Well child” doctor and dental visits are free through CHIP. There are services however that you might need to copay for. Also, you might have to pay a CHIP premium if you live in certain states. These premiums can change in price depending on the state where you live, but they will never cost more than 5% of a household’s annual income.

How to Qualify For CHIP

The thing about CHIP, which happens with other federal assistance programs, is that it was created by the federal government and then given to state governments to manage. That means state governments are in control of the benefits provided, as well as the qualifications required to be eligible for the programs.

To qualify for CHIP, a family must have an income that is too high to qualify for Medicaid (we’ll talk about that later). But that household also can’t make enough to pay for private health insurance.

Every state will provide CHIP coverage. Also, each state’s program works in close contact with the Medicaid program. You may apply for CHIP on any day of the year. To contact someone CHIP, you can use one of the following contact options:

  • Call 1-800-318-2596
  • You can apply through the Health Insurance Marketplace®. If eligible, your application will go to your state agency. Your state should contact you when they receive your information and process it.

Medicaid

The federal government created Medicaid to help low-income Americans. The idea is to provide affordable healthcare to those who otherwise wouldn’t be able to access healthcare at all. Just like CHIP, Medicaid was created by the federal government and then delegated to state governments to run it. That means benefits and qualifications may vary according to the state you live in. However, the program has a general list of eligibility terms that you should meet to qualify:

  • US citizens and eligible immigrants only
  • You must reside in the state in which you apply for Medicaid
  • You must satisfy some sort of low-income status

Medicare

This program’s name is a bit similar to Medicaid. So, if you get confused between the two, we won’t blame you. However, there’s a significant difference between both programs. While Medicaid helps low-income families and individuals of all ages, Medicare focuses on helping elderly people.

Medicare is a national healthcare program that helps people 65 years old or older. Under certain circumstances, people younger than 65 may apply for Medicare as well. People younger than 65 who want to apply for Medicare must also qualify for and receive benefits from the Social Security Disability for at least 24 months. On the other hand, people who have End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig’s disease) do not have to follow the 24-months rule.

Medicare is pretty complex though. Medicare offers its benefits in ‘parts.’ Each of these parts covers a different segment of healthcare costs. So, let’s understand these parts, in order for you to apply while having the knowledge necessary.

  • A: Hospital Insurance
  • B: Medical Insurance
  • C: Medicare advantages (usually offered by private insurance companies enrolled in the Medicare program)
  • D: Medicare prescription drug coverage

Keep in mind that beneficiaries will need to pay different premiums for each part. Also, it’s possible to be enrolled in both Medicare and Medicaid at the same time, if eligible.

Supplemental Security Disability Insurance (SSDI)

SSDI will provide healthcare coverage to those who’ve worked long enough and suffer from a disability that gets in the way of being able to work any longer. The disability must render them unable to work for at least 12 months or must be considered terminal for the applicant to qualify for SSDI.

There is also a program called Supplemental Security Income (SSI). SSI can also help disabled individuals and their families should their income be too low to afford proper healthcare.

You need to understand who’s eligible for these programs before applying. It might also be a good idea to check out this list of qualifications before applying. To apply, you first need to give information about your occupation:

  • The amount of money earned last year and this year.
  • The name and address of your employer(s) for this year and last year.
  • Beginning and ending dates of any active U.S. military service you had before 1968.
  • A list of the jobs (up to 5) that you had in the 15 years before you became unable to work and the dates you worked at those jobs.
  • Information about any workers’ compensation, black lung, and/or similar benefits you filed, or intend to file for.

After that, you’ll need to provide information about your medical condition/disability:

  • Name, address, and phone number of someone we can contact who knows about your medical conditions and can help with your application.
  • Detailed information about your medical illnesses, injuries, or conditions:
  • Names, addresses, phone numbers, patient ID numbers, and dates of treatment for all doctors, hospitals, and clinics.
  • Medicines you are taking and who prescribed them.
  • Types and dates of medical tests you have had and who ordered them.

Finally, you’ll need to give personal information about the applicant:

  • Date and place of birth
  • Social security number
  • All information concerning current or past spouses. That will include names, social security numbers, and dates of birth. You should also have information about the place and date of marriage/divorce/death of spouses.
  • Your bank or other financial institution’s Routing Transit Number and the account number.

Now, Onto The Documents You’ll Need For Your SSDI/SSI Application

  • Birth certificate or other proof of birth.
  • Proof of U.S. citizenship or lawful alien status if you were not born in the United States.
  • U.S. military discharge paper(s) if you had military service before 1968.
  • W-2 forms(s) and/or self-employment tax returns for last year.
  • Medical records, doctors’ reports, and recent test results.
  • Proof of any temporary or permanent workers’ compensation-type benefits you received

The Typical Application Process For SSDI And SSI

You can choose to apply for SSDI and SSI in person, over the phone, or on the internet. It shouldn’t matter how you choose to apply, the process should take the same course in all cases:

  • You’ll need to have all information and documents required before applying
  • Then you can start filling in your application (If you’re applying online, go to the Apply For Benefits page. That page will also have a “Getting Ready” section that helps you make sure you have all the information and documents needed)
  • After filling in your application and submitting it Social Security services will review it and make sure you meet the basic requirements.
  • Reviewers will check on your work history and current professional activities
  • After processing the application, Social Security services will forward it to the Disability Determination Services office in your state.
  • The Disability Determination Services office in your state will then decide on whether you qualify or not

Once you’re done submitting your application, Social Security should take a little while to contact you via mail. If you applied online, you can check your personal Social Security account. You can also contact the concerned office by phone at 1-800-772-1213. You may also appeal any decision regarding your entitlement to disability benefits.

Veteran Healthcare Assistance

Our brave servicemen and women put their lives and livelihoods on the line to serve our nation. That’s why our government takes extra steps to show its appreciation for their sacrifice. The federal government created specific healthcare assistance programs to serve our veterans. These programs aim to help veterans recover from any injuries or illnesses while avoiding putting themselves under financial stress. To qualify for Veteran Healthcare Assistance, an applicant must meet one of the following terms:

  • The applicant enlisted after September 7, 1980, or entered active duty after October 16, 1981.
  • If the applicant is a current or former member of the Reserves or National Guard

While Veteran Affairs (VA) might consider the length of the applicant’s service period, they may also disregard it if the applicant fits one of the following criteria:

  • The applicant quit the service due to a disability that was caused or made worse by your active-duty service.
  • If the applicant served before September 7, 1980.
  • The veteran was discharged for hardship or “early out.”

Benefits Of The Veteran Healthcare Assistance

Veteran Affairs (VA) is all about taking care of veterans and their well-being. VA created this program to show appreciation to those who chose to put their lives on the line for the country. VA offers this program to achieve the following for veterans:

  • Treat current injuries and illnesses
  • Prevent future health problems
  • Increase the chances of functioning normally daily
  • Improving veterans’ quality of life

While all veterans may receive benefits from VA, some veterans may be able to receive extra benefits, such as dental care. That all depends on the veteran’s priority group, the advice from the veteran’s primary healthcare provider, and the available medical standards to treat the veteran’s current condition.

You can apply for veteran healthcare assistance through this link. You can also call VA on the toll-free number 877-222-8387, Monday through Friday, 8:00 a.m. to 8:00 p.m. ET.

Conclusion

Regardless of what your profession is, whether you’re married or not, or what your income level is, the government might have a healthcare assistance program for you. So hop onto Benefits.gov and explore your options.