State Government Insurance Programs Offered

AHIP

AHIP - Alabama Health Insurance Plan www.alseib.org There are two plan options under this program: Indemnity and Managed Care plans. This plan is designed for those who have exhausted their group plan coverage and are not eligible to apply for another group coverage. This is in accordance with the Health Insurance Portability and Accountability Act (HIPAA). Eligibility requirements: - must be a resident of Alabama - the plan you previously had must also be a group plan, government plan, church plan or COBRA - must have continuous coverage of at least 18 months - your previous coverage must not have lapsed for more than 62 days

COBRA

Consolidated Omnibus Budget Reconciliation Act (COBRA) ensures that employees who have reduced work hours or those who are losing their jobs can keep their health care coverage for up to 18 months. Under COBRA, the coverage will be more expensive since the member now has to pay for 100% of the coverage cost.

Pre-Existing Condition Insurance Plan (PCIP)

www.PCIP.gov A federal program focused on providing coverage to people who have a pre-existing condition. Eligibility requirements: - must be a US citizen and should be able to show proof of citizenship or residency - must be without coverage for at least 6 months - must be having a problem getting approved because of a condition

Medicaid

Medicaid - SOBRA and MLIF MLIF - Medicaid for Low Income Families insurealabama.adph.state.al.us SOBRA Medicaid is a program designed for children and pregnant women. Eligibility requirements: - must be a US citizen and a resident of Alabama or a legal alien - must not be eligible for ALL Kids Income limits: - Pregnant Women: 133% FPL. - Children (ages 0–5): 133% FPL. - Children (ages 6–18): 100% FPL. - Parents/caretakers living with children ages 0–18: 24% FPL. - Aged, blind and disabled: Singles with incomes up to 75% FPL and asset limit of $2,000, and couples with incomes up to 83% FPL with asset limit of $3,000. (source: coverageforall.com)

ALL Kids

insurealabama.adph.state.al.us or www.adph.org/allkids ALL Kids is a state program that provides coverage to low-income families with children below the age of 18 who are uninsured. Coverage can start on the 1st day of the month right after application. Duration of coverage is 12 months. Benefits include doctor visits, check-ups, hospital care, immunizations, prescription drugs, dental and vision care, emergency services, and mental health/substance abuse services. Eligibility requirements: - Must be a US citizen or legal immigrant - Must be below 19 years old - Must be ineligible for Medicaid - Cannot acquire coverage - For children 5 years old and below, income must be between 133%–300% of the federal poverty level (FPL) - For children between 6-18 years old, income must be 100% - 300% FPL

AL Child Caring Program

insurealabama.adph.state.al.us Gives outpatient coverage only. Eligibility requirements: - must not be eligible for ALL Kids program and other plans - must be enrolled in school (if the child is of school age)

Breast and Cervical Cancer Prevention

www.adph.org/earlydetection Gives coverage for Pelvic exam, Pap smear, clinical breast exam, mammogram, ultrasound, colonoscopy, or biopsy, if necessary. Eligibility requirements: - women aged between 40–64 - must be uninsured or underinsured - income must not be higher than 200% of the FPL - women below the age of 40 can avail of free breast cancer screening provided that they undergo a clinical breast exam.

Medicare

A federal health care system that provides coverage to America's seniors (aged 65 or older) or those under 65 but with a disability or end-stage renal disease. Medicare has 4 parts: Part A which covers hospital care is free of charge; Part B covers medical care. Members need to pay for Part B coverage at a minimal cost. Part c is a combination of the coverage of Parts A and B which members can purchase from Medicare-approved private insurers. Part D covers prescription drugs which are also purchased through private insurance companies.

Health Coverage Tax Credit

www.irs.gov (keyword: HCTC) Covers inpatient care, outpatient care (lab tests, x-rays, etc.), doctor visits, preventive care, major medical care (surgery, physical therapy, durable medical equipment, etc.), mental health and substance abuse care, and prescription drugs. Eligibility requirements: - Must be receiving TAA (Trade Adjustment Assistance) - Must be 55 years or older and receiving pension from the Pension Benefit Guaranty Corporation (PBGC). - Must not be enrolled in other state plans, or in prison - Must not be receiving 65% COBRA premium reduction - Must not be a dependent in tax returns - Must be enrolled in qualified health plans where you pay more than 50% of the premiums. - Individuals who are eligible for the federal Health Coverage Tax Credit can also use their credit funds to purchase a private health insurance product developed by Blue Cross Blue Shield of Alabama.

VA Medical Benefits Package

www.va.gov Provides comprehensive preventive and primary care, outpatient and inpatient services. Covers pre-existing condition. Eligibility requirement: ”Veteran status” = active duty in the U.S. military, naval, or air service and a discharge or release from active military service under other than dishonorable conditions.Certain veterans must have completed 24 continuous months of service.