Health Insurance Overview
Health care is expensive and few individuals can afford to pay the full costs. Having health insurance allows you to get the treatment you need without incurring huge medical bills.
Under the Affordable Care Act, all Americans can get health insurance regardless of income or health history.
Enrollment in the Health Insurance Marketplace for 2015 has closed. The next open enrollment period will be November 1, 2015 through January 31, 2016. If you experience a qualifying life event outside of the open enrollment period, you may be eligible to sign up for health insurance through a special enrollment period.
If you're looking for private plans outside of the Health Insurance Marketplace, search the Plan Finder. Getting coverage through private plans is also generally limited to an open enrollment period.
There is no limited enrollment period for Medicaid or the Children's Health Insurance Program. If you qualify, you can enroll at any time.
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States decide on the benefits provided under Medicaid, but Medicaid usually provides health care for low-income children and families, and people with disabilities. Covered services usually include doctor visits, hospital care, vaccinations, prescription drugs, vision, hearing, long-term care, and preventive care for children.
Medicare is a government health insurance plan for people 65 or older, people under 65 with certain disabilities, and people with end-stage renal disease. Medicare helps to pay for care in hospitals, skilled nursing facilities, hospice care, and some home health care. Coverage can also include doctors’ services and prescription drugs.
- Medicare – Learn about the Medicare program; enroll online; and find a Medicare-enrolled doctor or health care facility.
- Replace Your Medicare Card – If your Medicare card is lost, stolen, or damaged, you can ask for a new one online.
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COBRA: Keep Your Insurance If You Leave Your Job
The Consolidated Omnibus Budget Reconciliation Act (COBRA) can help you temporarily keep health insurance you had through your employer after you've left your job.
During open enrollment in the Health Insurance Marketplace, you can replace your COBRA coverage with a Marketplace plan. Learn more about COBRA and the Marketplace.
Health Insurance for Children: CHIP
The Children’s Health Insurance Program (CHIP) provides free or low-cost health coverage for low-income children. Each state decides on the benefits provided under CHIP, but all states cover routine check-ups, immunizations, hospital care, dental care, and lab and x-ray services.
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How to Appeal a Health Insurance Claim
If your health insurer has denied coverage for medical care you received, you have the right to appeal the claim, and ask that the company reverse that decision. You can be your own health care advocate. Follow these five steps:
- Review your policy and explanation of benefits.
- Contact your insurer and keep detailed records of your contacts (copies of letters, time and date of conversations).
- Request documentation from your doctor or employer to support your case.
- Write a formal complaint letter explaining what care was denied and why you are appealing through use of the company's internal review process.
- If the internal appeal is not granted through step four, file a claim with your state's insurance department.
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