Options for Bridging the Health Insurance Coverage Gap

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Tuesday, February 10, 2015

The Affordable Care Act originally planned to expand Medicaid's reach to all low-income Americans. This would have provided people with quality insurance, even if their income fell below the limit to qualify for a federal subsidy. Unfortunately, things don't always go as planned and the refusal to expand Medicaid has left many Americans lost in the depths of the coverage gap. There is hope, however. If you are ineligible for your state's Medicaid program, these options can help you bridge the gap and get the coverage you need.

Apply anyway

If you need budget-friendly insurance, you should apply at Healthcare.gov even if you don't think you can afford it. Submitting an application will let you know for sure whether or not you qualify for Medicaid or a federal subsidy. You may be eligible for more help than you think. Even if your application is denied, applying now can still benefit you in the future.

Reserve your seat at Healthcare.gov

Even if you don't qualify for assistance right now, your marketplace application can still provide an important lifeline when it's finally time to scale the walls of the coverage gap. People within the coverage gap often have unsteady incomes. You may be between jobs, working a seasonal job, or perhaps your income changes from month to month. If you start earning enough to qualify for a subsidy, having an application already on file reserves your right to a 'special enrollment period.' A special enrollment period allows you to buy insurance from the Marketplace and get financial assistance during closed enrollment. So reserve your seat at the table and apply today.

Ease your burdens with a hardship exemption: If your state didn't participate in the Medicaid expansion, you can apply for a hardship exemption. Hardship exemptions provide assistance to people who can't afford insurance due to certain life events. A hardship exemption excuses you from the tax penalty assessed to people who don't have insurance and it allows you to buy cheaper 'catastrophic insurance' from the Marketplace. Hardship exemptions are typically provided for three months: the month before the hardship, the month of the hardship, and the month after. If you need more time, it's possible to extend your exemption up to a full calendar year. If your hardship exemption is based on affordability, if your state opted out of the Medicaid expansion, or if you are eligible for Indian Health Services, your hardship exemption can be extended for a full year.

Call your local insurance broker

If you aren't eligible for a subsidy and you're in need of a good deal, an insurance broker may be able to help you find just what you're looking for. Insurance brokers have access to hundreds of plans from multiple companies, including plans that aren't listed at the Marketplace. Their insider knowledge can help you find the perfect plan to protect your health and your wallet.

Utilize your local community health center

Community health centers provide low-cost healthcare services to low-income people, the uninsured, people with limited English proficiency, migrant and seasonal farm workers, the homeless, and people who live in public housing. The prices are based on income and discounts are offered based on the patient's ability to pay. Patients whose income falls below 100% of the federal poverty guidelines will receive a full discount. Patients whose income falls between 100% and 200% of poverty will be charged on a sliding scale based on family size and income. If a patient's income is above 200% of poverty, they will have to pay full price. Community health centers will not deny a patient even if they are unable to pay. Patients who are unable to pay for healthcare services will have their fees reduced or waived.

Falling into the coverage gap isn't a hopeless situation. Checking all of your options is the first step to climbing your way out of the canyon. Even if you don't qualify for Medicaid, there are still several ways to get budget friendly insurance. Bridging the gap isn't always ideal but it's far better than going without and falling into a void of excessive medical bills. Do your homework, protect yourself, and get covered!

ObamaCare.com, Inc.
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