Low Cost Health Insurance

Some people would argue there is a national healthcare crisis here in the United States, and low cost health insurance should be available to all citizens.  While that last statement is certainly debatable, we'll address the issue of low cost health insurance in the article below.

We're going to do that by first highlighting some recent health care statistics, including health insurance coverage.  For those individuals that are looking for some low cost options, we'll explain how to figure out if a family qualifies for low cost, or no cost, health insurance.  We'll also explain where to find information to determine if someone qualifies for government-sponsored programs.

Health Insurance Coverage

Additional Resources

Each year, government agencies such as the Census Bureau and the U.S. Department of Health and Human Services conduct surveys aimed at determining the numbers of people in the United States covered by health insurance plans.  The latest statistics (September 2013) from those agencies tell us:

  • The total number of individuals in the United States with health insurance coverage increased from 260.2 million in 2011 to 263.2 million in 2012.
  • There were approximately 48.0 million people in the U.S. without health insurance coverage in 2012, which is down from 48.6 million people in 2011.  On a percentage basis, this represents a decrease from 15.7% to 15.4% of the population.
  • Most individuals in the U.S. (54.9%) were covered by employer health insurance plans in 2012.
  • The number of people covered by government-sponsored health insurance programs increased to 101.5 million people, which is 32.6% of the population.
  • Nearly 9% of all children living in poverty do not have health insurance.

That last statistic is particularly disturbing because there are programs aimed at delivering low cost or no cost health insurance to children.

Children's' Health Insurance Program

The Children's Health Insurance Program, or CHIP, is a program jointly sponsored by federal and state governments to offer, and expand, low cost and no cost health care coverage to over 5 million children throughout the nation.  (The program was formerly known as State Children's Health Insurance Program, or SCHIP)

The program provides for over $60 billion in federal funding as well as state matching funds.  Each state has the flexibility to establish their criteria for eligible uninsured children.  Alternatively, they can choose to use this money to expand their existing Medicaid programs, or design a specific program aimed at child health care services.

Typical medical care offered under this program includes:

  • Doctor Visits (including well care services such as immunizations)
  • Prescription Drugs / Medicines
  • Hospitalizations / Hospital Care

Perhaps the most popular program run today under CHIP is the Insure Kids Now initiative.

Qualifying for Health Insurance Under Insure Kids Now

Parents can qualify for low cost health insurance for their children if they are age 18 years and younger and they meet certain eligibility rules.  For example, a family of four that earns $45,100 or less qualifies for the program (2013 / 2014).

These programs are run by all 50 states and are founded on legislation passed in 1997.  Eligibility is based on income levels and the size of the family.  If Medicaid already covers the child, then they have access to health insurance and are not eligible for this program.

Each state has its own program, and it's possible to follow this link to find a state's offering.  These low cost health insurance programs are funded through taxes collected at both the federal and state level.  Generally, the insurance covers doctor visits, prescriptions, and hospital stays.  Some states will also cover the cost of dental care, eye examinations, and specialized medical equipment a child might need.

Applying for Low Cost Health Insurance

The application process is designed to be very simple and very short.  Most states offer the choice between completing the application through the mail and even applying over the telephone.  Parents are not required to give their Social Security number when applying for insurance, but the Social Security number of the insured children will be needed.

Additional information needed to complete the health insurance application includes proof of the family's income, any childcare costs currently paid, and some information concerning the last time the child was covered by a health insurance plan.

Congress recognizes that low cost and no cost health insurance is important for many reasons.  Immunizations can help prevent disease.  Parents should be able to bring their child to a doctor when they are sick and not have to worry if they can afford to pay for the medical care administered.  Studies confirm that children with health insurance live more healthy lives, miss school less often, and therefore perform better in school.  Providing low cost health insurance to children is an important step in securing America's future.

Low Cost Health Insurance through Medicaid

Anyone that is a U.S. national, citizen, or permanent resident, may qualify for low cost health care insurance under the Medicaid program.  Assistance is generally offered to individuals and families with income at or near the poverty level.  Each state is responsible for establishing their guidelines to receive Medicaid benefits.

Health Care Services through Medicaid

In order for state run programs to be eligible to receive federal matching funds, there are certain basic medical / health care services that must be offered to needy populations.  For example, the health care help available through this program must include services such as:

  • Inpatient and outpatient hospital services
  • Payment of physician services
  • Surgical and medical dental services
  • Nursing facility (NF) services for individuals aged 21 or older
  • Home health care for persons that are eligible for nursing facility services
  • Family planning services and supplies
  • Nurse / midwife services
  • Laboratory services and X-rays
  • Pediatric and those services provided by a family nurse practitioner
  • Federally-qualified health center services and ambulatory services that are otherwise covered under a state plan
  • Rural health clinic services and other ambulatory services that are otherwise covered under a state plan

States may also provide home or community-based care waiver services to certain individuals who are eligible for Medicaid.  Such services can include case management, personal care services, respite care, adult day health services, and home health aides.  We've provided more information about this important and helpful program in our article on Medicaid Benefits.


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