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How to Qualify for Free Healthcare

A brief overview...
  • In states that expanded Medicaid, anyone with an income below 138 percent of the federal poverty level qualifies for Medicaid coverage, which is typically free of cost
  • Children from low-income families may qualify for free health insurance under the Children’s Health Insurance Program
  • You can apply for these services through the health care exchange marketplace or through your state Medicaid agency
  • If you are 65 or older and worked and paid Medicare taxes for 40 or more quarters, you should qualify for premium-free Medicare Part A
  • If you are already receiving Social Security or Railroad disability or retirement benefits, you might also qualify for free Medicare Part A

How do I qualify for Medicaid?

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In states that expanded Medicaid, anyone with an income below 138 percent of the federal poverty level should qualify for free or low-cost insurance. This means that single individuals with an income of $16,643 or less and families of four with an income of $33,948 or less are eligible for Medicaid.

If you live in a state that did not expand Medicaid, you might still be eligible for the program. Eligibility will vary for each state and will be determined by factors such as income, size of your household, and family status. You should apply if your income is below the limit even if your state did not expand their Medicaid program.

States that did not expand Medicaid include Idaho, Wyoming, Utah, South Dakota, Nebraska, Kansas, Oklahoma, Texas, Missouri, Wisconsin, Tennessee, Alabama, Mississippi, Georgia, Florida, South Carolina, North Carolina, Virginia, and Maine. If you live in any of these states and do not qualify for Medicaid but would have if your state expanded, you should be exempt from the individual mandate penalty fine and will not have to get health insurance.

Find health insurance in your state by comparing free quotes using our zip code tool above!

How do I or my children qualify for the Children’s Health Insurance Program?

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If you are looking for free or low-cost insurance for your children, you should consider applying for the Children’s Health Insurance Program. In some states, the Children’s Health Insurance Program covers pregnant women as well. The Children’s Health Insurance Program is typically for children of low-income families that earn too much to qualify for Medicaid. The program works closely with each state’s Medicaid program.

In many cases, it is free but it will depend on the state’s eligibility requirements and the family’s income. All wellness visits to a primary care doctor and visits to the dentist are free under the Children’s Health Insurance Program. Other services may require some out-of-pocket costs.

If you are required to pay a monthly premium, it will never be more than 5 percent of your family’s income for that year. If your children are eligible for the Children’s Health Insurance Program, they will not qualify for tax subsidies and other cost assistance on marketplace plans.

The Children’s Health Insurance Program benefits vary depending on the state. However, each state’s program must cover vaccinations, well visits, dental and vision services, hospital care, prescription drugs, laboratory tests, X-rays, and emergency services.

How do I apply for Medicaid or the Children’s Health Insurance Program?

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You can apply for Medicaid and the Children’s Health Insurance Program online by filling out a marketplace application. If it looks like you qualify, the marketplace will forward your application to your state Medicaid agency. A representative will then contact you about your next steps. You can also apply by directly contacting your state Medicaid agency.

You do not have to wait for a special enrollment period to apply for Medicaid or the Children’s Health Insurance Program. You can apply at any time and, in most cases, your coverage can start almost immediately.

Medicare costs and benefits vary from state to state. Some Medicaid programs may contract out through a private insurance company. If you qualify for Medicaid, you will not be eligible for tax subsidies and other savings on marketplace plans. For this reason, you should enroll in Medicaid if you are eligible. If you do not enroll in any insurance plan, you might be responsible for paying the individual mandate penalty fine unless you qualify for an exemption.

Some states offer limited Medicaid coverage. These programs typically do not count as minimum essential coverage and only cover a particular service. You might still be responsible for paying the individual mandate penalty fine if you only enroll in one of these programs.

Examples of limited Medicaid programs includes ones that only cover family planning, emergency care, tuberculosis care, and outpatient hospital services. If you have limited Medicaid coverage, you can still qualify for savings on a Marketplace health insurance plan.

How do I cancel my current plan if I qualify for free or low-cost coverage?

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If you are already enrolled in a health insurance plan through the marketplace or your employer and you find out you qualify for Medicaid or the Children’s Health Insurance Program, you should cancel your current plan, particularly if it is a marketplace plan. You will no longer be eligible for savings so it is important to cancel the marketplace plan or you will have to pay the full price.

If representatives at the marketplace notice that you are enrolled in both a marketplace plan with savings and Medicaid or CHIP, you will get a notice in the mail. It will tell you which household members are enrolled in multiple low-cost plans and what your next steps to rectify this situation should be. You will need to take action on your enrollment within 30 days of receiving the notice in the mail.

How do I qualify for premium-free Medicare Part A?

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If you or your spouse worked and paid 40 quarters worth of Medicare tax credits, you should be eligible for premium-free Medicare Part A when you reach the age of 65. Most people do qualify for premium-free Medicare. If you are automatically enrolled in Medicare Part A, you will receive your Medicare card three months before you turn 65.

However, some people will need to sign up for Medicare Part A during their initial open enrollment period. This is typically a seven-month period that begins three months before your 65th birthday and ends three months after your 65th birthday. If you do not enroll during your initial enrollment period, you may have to pay a late penalty.

Some people under the age of 65 are also eligible for premium-free Medicare Part A. Those who have received Social Security or Railroad disability benefits for 24 months are typically eligible as well.

If you are automatically enrolled, you will receive your Medicare card in the mail on your 25th month of disability. If you have End Stage Renal Disease and meet specific qualifications, you may also be eligible for premium-free Medicare Part A.

If you did not work and pay Medicare taxes for 40 quarters, you still have the option to purchase Medicare Part A. It will be less expensive for those who worked between 30 and 39 quarters than for those who worked under 30 quarters.

Do I have to pay anything for Medicare Part A?

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If you qualify for premium-free Medicare Part A, you may still have to pay some out of pocket costs depending on the medical services you need. You will not have to pay anything for most home health care services but you may have to pay a 20 percent coinsurance for any necessary durable medical equipment. Most hospice related services are free of cost, as well. However, you may have to pay a small copayment for prescription drugs.

If you need to stay in the hospital for a certain period of time, you will have to meet a $1,316 deductible. For the first 60 days, you will not have to pay any additional coinsurance. Once you go beyond those 60 days, you will have to pay a daily coinsurance amount. The same financial restrictions apply to inpatient mental health care.

How to Qualify for Free Healthcare

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In order to qualify for a free or low-cost health insurance programs like Medicaid or the Children’s Health Insurance program, you will have to meet certain income requirements. In some states that did not participate in the Medicaid expansion program under the Affordable Care Act, there may be additional factors that determine your eligibility for free healthcare including household size, family status, and disability status.

If you are 65 or older and worked for a certain period of time or are on your 25th month of disability, you should qualify for premium-free Medicare Part A. There may be some out of pocket costs associated with Medicare Part A, although you will have no monthly costs.

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