For Any Cancer Diagnosis
Q. Now that March 31 cut-off date for the Affordable Care Act has passed, how do people apply for health insurance? My dad had to go to the emergency room a couple of days ago and they suspect cancer. He has no insurance. How do we apply for help?
Yes, Open enrollment for 2014 coverage is over, but you may still have options to get health coverage. Some of the options are:
You can still enroll in a private health plan through the Marketplace if you qualify for a special enrollment period. You can qualify for a special enrollment period if you have a qualifying life event. A qualifying life event could include getting married, divorced, moving to a new area or losing other health coverage, for example. To learn more about the special enrollment period and what constitutes special circumstances, please visit www.healthcare.gov/sep-list. If you think that you qualify for a special enrollment period you can call the Marketplace Call Center at 800-318-2596 and speak with a representative to determine if your circumstances qualify.
There are no enrollment time restrictions for Medicaid and the Children’s Health Insurance Program (CHIP). In all states, Medicaid and CHIP provide health coverage for some individuals, families, and women, the elderly with certain incomes and people with disabilities. You need to check the Medicaid eligibility regulations of your state. A cancer diagnosis would constitute a disability. For more information about eligibility in your state please visit: www.healthcare.gov/do-i-qualify-for-medicaid/.
Private plans outside the Marketplace. In some limited cases, some insurance companies may sell private health plans outside the Marketplace and outside open enrollment that count as minimum essential coverage. These plans meet all the requirements of the health care law, including covering pre-existing conditions, free preventive care and not capping annual benefits. Insurance companies, agents, brokers and online health insurance sellers may offer these plans outside of the Marketplace. The Marketplace does not list or offer these plans nor can you get premium tax or lower out of pocket costs for plans you buy outside the Marketplace. To learn more, you can call insurance companies directly or work with an insurance agent or broker. Your state insurance department will know what companies are operating in your state.
Q. I know the Affordable Care Act deadline has passed for signing up this year, but could you explain Medicaid expansion? Is it easier to get Medicaid now?
Even though the deadline for the ACA has passed, qualified patients can sign up for Medicaid any time of the year. Free or low cost health care coverage through Medicaid is based on income and family size.
In all states, Medicaid provides heath coverage for some low-income people, families and children, pregnant women, low-income elderly and people with disabilities (and that includes people diagnosed with cancer). Medicaid programs must follow federal guidelines but they vary from state to state.
In 2014, Medicaid was expanded to include individuals between the ages of 19-65 (parents and adults without dependent children) with incomes up to 138% of the Federal Poverty Limit ($16,105 for an individual and $31,809 for a family of four).
Not all states expanded their Medicaid program (view map for more information), but if you have a disability you may still qualify under your states existing rules.
To find out if you qualify for Medicaid in your state, please visit your state’s Medicaid website or visit this section of healthcare.gov.