Focus on an Issue: Health Insurance for the Uninsured
26 12 07 - 11:49
Tens of millions of Americans, whether single, married, or married with children, face each day without the protection of health insurance. If you're one of them, or know someone who is, the questions and answers below are for you.
Will my health care providers continue my care even if I owe them money? Will they require a deposit before providing care?
That depends on the provider. Many hospitals and medical groups can and will put you in touch with public and private payment assistance programs, even if you owe them money. On the other hand, some could deny you care until your older bills are paid, at least in part.
Are free or reduced-cost health care programs available in my area?
All states in the U.S. offer Medicaid health insurance to low-income people. If you don't qualify for Medicaid, you may still qualify for subsidized insurance. Many areas have reduced-cost health programs, and many hospitals and health providers offer assistance in the form of installment payment plans, discounts, or more rarely, fee waiving.
Should I use a credit card or home equity loan to pay medical bills?
Bill Brennock, certified consumer credit counselor for Consumer Credit Counseling Service, says no. Don't put your future credit or your home in danger by overburdening credit cards or risking the loss of your home. Talk to health care providers and financial counselors before taking that chance.
If I have bills but can't pay them, how soon must I act?
Immediately, says Bill Brenncok. Health care providers are likely to be more willing to negotiate payment plans or reduced payments than collection companies once bills have been turned over to them.
What should I keep in mind when filling out insurance applications?
Give only the information requested, and nothing more.
What is a high-risk pool?
High-risk pools operate in many states to help people who've been denied coverage because of pre-existing medical conditions or who can only get insurance for very high premiums. States allow high-risk people to pool together in order to share the risk, then subsidize their insurance so that coverage is more affordable.
What are "guaranteed issue" and "community rate," required by some states?
"Guaranteed issue" regulations require insurers to sell coverage to nearly everyone, regardless of pre-existing medical conditions or other factors. Of course insurers may still charge different rates depending on risk.
"Community rating" is similar to guaranteed issue. It requires insurers to calculate the risk of an entire population, or community, of people, and then charge everyone within that community the same insurance rates regardless of age, sex, health status, or other factors.
How can I find out what my state requires of health insurance carriers?
Each state has a State Health Insurance Assistance Program. A complete list is available at http://www.Medicare.gov/contacts/static/allStateContacts.asp. The Web site http://www.healthinsuranceinfo.net/ also has a clickable map with information on insurance for each state.
What happens if I am rejected when I apply to insurance carriers?
Most states have high-risk pools like the one described above that you may be able to buy into. Still, sometimes premiums can still be prohibitively high, even within those program. If you have a low income, you could qualify for Medicaid or another low-income assistance program. Your State Health Insurance Assistance Program can help you figure out the options in your area.
Married With ChildrenIf I cannot afford the cost of health care insurance, what help is available to get insurance for my children?
Insurance is very important, and researchers report that millions of kids go without coverage even when they are eligible for assistance program. Every state, in partnership with the federal government, offers Medicaid and a State Children's Health Insurance Program, or SCHIP. Medicaid generally covers kids living in families below 125% of the federal poverty level, while SCHIP covers kids above the Medicaid threshold up to 300% of poverty, depending on the state.
What else is happening in my state to extend health insurance benefits to children?
States are doing a lot of experimenting with new policies designed to cover more adults and children. Vermont, Massachusetts, Washington, Maine, Illinois, Hawaii, and Wisconsin all have laws on the books designed to cover all children. Several other states are working on similar proposals.
Meanwhile, Congress continues debating a possible expansion of SCHIP. Proposals on the table now would expand SCHIP's total enrollment from about 6 million children now to about 10 million.