State and Federal Plans
With the change in health care laws over the past five years, what is available through state and federal funded programs has evolved.
Changes in benefits, as well as to Medicaid and CHIP, can be confusing and it’s important to fully investigate the benefits you can receive from state programs to understand if a private insurance plan is a better option.
Parents' Extended Group Benefits
Because of the Health Care Reform Act, or ObamaCare, a teenager or young adult is able to remain on his or her parents' insurance plan until he or she is 26 years old. If a plan covers children, a parent can add their daughter or son to their policy.
The child can remain on the plan, no matter what, until his 26th birthday. Previously, things such as being married or attending college affected this type of coverage, however marriage, where the child lives, if the child is attending school and even if the child is financially dependent or independent are all factors that no longer matter.
After the child’s 26th birthday, they qualify for a special enrollment period so they can get a health plan outside of open enrollment. This period ends after 60 days.
By not enrolling in a health coverage plan within 60 days, there’s a chance they will not be able to get coverage until the following open enrollment period, so it’s important to have a plan of action before your birthday. Talking to a health insurance broker is a great way to be prepared for this change.
State-run Childen’s Health Insurance Programs (CHIP)
In order to have a teenager covered by Arizona KidsCare, Arizona’s Children’s Health Insurance Programs (CHIP) incentive, children or teenagers must already be a part of the KidsCare program.
Because of a lack of financial support, the funding for the program was frozen in January of 2010; however, it is still accepting applications, as well as processing renewals and changes for eligible children who are already a part of the program.
Although new children are not currently being accepted into the program, applications from eligible families will put those children on a waiting list for if the program is restored. Eligibility for this program is based on income.
Medicaid is the government managed health program funded by both the states and the federal government. It provides health coverage to Americans who qualify, including those with a low-income, pregnant women, elderly adults and people with disabilities.
Qualifications for Medicaid are based on income, disability, family status and household size. The eligibility is different in all states, so checking the eligibility requirements in Arizona is important before assuming you will be covered by Medicaid.
To apply for Medicaid you can either go directly to the state Medicaid agency or fill out an application on Marketplace, which is the government managed health insurance site. It’s possible to apply for Medicaid at any time of the year and not just during the Marketplace Open Enrollment period.
In Arizona, Medicaid is expanding its program to cover households with incomes that are up to 138% of the federal poverty level. For one young adult that would mean the income would have to be at $16,243 a year or less.
Student Coverage Options
As a college student there are more options to get low-cost insurance.
Universities typically offer full-time students some type of student health plan, and most health insurance companies offer a low-cost health insurance specifically for college students. Unfortunately, there is no exemption from the no-coverage penalty for students, so it’s important to find the right coverage or be prepared to pay the penalty.
College Health Systems
Some colleges, including colleges in the Phoenix and Scottsdale area, offer College Health Systems or some type of student health plan.
This provides current, full-time students with coverage for health-related expenses. This type of coverage can vary by college and it’s important to investigate what your university may have to offer.
Check the university’s website for more information and make an appointment to talk with a representative at the university so that you know what is available to you and if it is the best source of coverage you can afford.
Student Health Insurance
Most health insurance companies offer some type of student health insurance for college-aged students.
These plans are designed for preventative care, doctor visits and any type of hospitalization. For a healthy college student, this type of plan is great. To be sure it is the right insurance option for you, talk to a Scottsdale health insurance broker to better understand these types of options.
When a young adult isn’t covered by his or her parent’s insurance, is no longer a student and is working to be above the poverty line just enough to disqualify for state-aid, buying insurance can seem like an expensive and painful venture.
Some may opt to take a chance and pay the no insurance penalty; however, the risk of an unexpected illness or injury can cause a person who thinks he or she is saving money to pay more in the long-term. Luckily, options such as temporary or catastrophic health insurance allow young adults peace of mind at a lower cost.
Temporary Health Insurance
As a teenager who will soon be eligible for college or group health insurance, but is ineligible for other Arizona health insurance, it’s possible to opt into a temporary health insurance plan.
These plans are available for six months and typically are much more affordable than the usual preferred provider organization (PPO) or health maintenance organization (HMO). These plans come with a higher deductible but are a great option if the person doesn’t typically have health issues.
Catastrophic Health Plans
Similar to temporary health insurance, catastrophic health insurance has a higher deductible; however, it is available for more than six months. Catastrophic health plans, which are available to people under the age of 30, will mean that the person pays for most healthcare costs up to a certain amount, and after that the insurance company will pay its share.
It only covers those costs after you’ve had a lot of care. This insurance is meant to protect people from serious accidents or illnesses that are unexpected.
How to choose what is best
The best way to choose which insurance option will offer the best coverage, as well as the lowest premium, it’s always a good idea to talk to your Phoenix health insurance broker. Even if you are eligible for state-funded insurance options, a knowledgeable health insurance expert will be able to explain the pros and cons of each insurance plan with you and can help you make the best long-term decision.
Consulting with a health insurance broker is typically free, so don’t hesitate to call, email or stop by an office to put yourself in control of your health options.