Government-sponsored insurance plans provide individuals and families with access to health insurance.
The Centers for Disease Control and Prevention (CDC) reports that there are more than 50 million adults and children who do not have health insurance in the United States at some point in a given year. Factors such as unemployment and high health insurance premiums contribute to the high rate of uninsured persons. The government has developed several programs to assist people without insurance. Most government health insurance plans, however, require plan participants to meet income and other stipulations to obtain coverage.
Medicare and Medicaid
Medicare is a federal program that provides health insurance coverage to people 65 years of age or older, as well as some under 65 who have disabilities. Medicare pays a part of the cost of hospital bills, surgery, doctor's bills, nursing facility care and home health care. Medicaid is funded by both federal and state governments. It is a public assistance health insurance program for low-income individuals and families who cannot pay for health care.
Medicare and Medicaid recipients must meet eligibility requirements. For example, Medicare recipients must have worked at least 10 years in Medicare-covered employment and be at least 65 years of age. Recipients younger than age 65 may qualify for Medicare if they have a disability. Medicaid recipients must display financial need. Each state determines the specific definition of "financial need." In most cases, a Medicaid recipient's income cannot exceed a certain percentage of the federal poverty level.
State Insurance Pools
Many Americans do not have insurance because they are students, unemployed or self-employed. Some uninsured persons pose too much of a risk for private insurers to handle. State insurance pools are mandated by many state governments to provide health insurance to high-risk individuals who would otherwise not qualify for coverage.
Federal Insurance
Some people are uninsured because they have been turned down for coverage from a private insurer because of their health status. The federal government has a health insurance plan that provides insurance coverage for individuals who have a health condition that prevents them from obtaining traditional health insurance coverage. This government option is also available if the state where the recipient lives does not have a high-risk insurance plan. The Pre-Existing Condition Insurance Plan (PCIP) covers benefits such as primary and specialty care, hospital care and prescription drugs. Unlike Medicaid, the plan does not base eligibility on income. Also, PCIP plan participants are covered for health conditions that were present before the policy period began.
Considerations
Government-sponsored health insurance plans make it possible for individuals and families who would otherwise be uninsured to obtain affordable health care. The federal government has enacted legislation to support individuals with pre-existing conditions or individuals who do not qualify for Medicare or Medicaid. By 2014, all private insurers will be required to provide health coverage to applicants with health conditions without any exclusions. The legislation is designed to reduce the number of Americans who are uninsured because of their health.
Tags: health insurance, health care, individuals families, insurance coverage, insurance plans
