|
Health Coverage for Everyone!
Accessing health care and health insurance can be a complicated matter. There are several government-sponsored health insurance plans that can assist you and your family to meet their health care needs. Those plans include: Medicare, Medicaid, CHIP, and Adult Basic. It is also important that you and your family consider care of your teeth.
Medical insurance is a type of insurance that pays for medical expenses. It may be obtained through government-sponsored programs and private companies. It may be purchased on a group basis (through) an employer or you may have to pay for it separately. Private insurance options can be either HMOs or PPOs. HMOs are called Health Maintenance Organizations while PPOs are called Preferred Provider Organizations. In general health insurance covers emergency services, routine services, vision services, diagnostic services, and surgery.
When obtaining insurance you will typically pay premiums and deductibles. A premium is the amount the policyholder pays to the health plan each month to purchase coverage. If you have insurance through your employer they will pay either part of the premium or all of it. A deductible is the amount the insured must pay out-of-pocket before the health insurer pays its share. Usually you pay your deductible on a yearly basis.
It is important to know that no matter if you are insured or uninsured and regardless of you residency status, you may always seek emergency medical care. An emergency medical condition includes chest pain, difficulty breathing, bleeding that will not stop, confusion, active seizures, vomiting, and more.
Seek medical attention immediately in an emergency situation!!!!!!!!!
The health insurance programs available are:
Medicare:
- A program that provides coverage to people 65 and over or meet other special criteria
Eligibility
- 65 and over
- disabled receiving S.S. benefits
- end stage renal disease
Benefits
- Part A: Hospital Insurance
- Part B: Medical services
- Part C: Medicare Advantage
- Part D: Prescription drugs
*Legal immigrants who have been in the U.S. for 5 years or more are eligible for Medicare
Medicaid:
- Also called Medical Assistance in Pennsylvania
Eligibility
- Must be a PA state Resident
- Fit into a Medical Assistance “Category”à children under 18, Permanent and/or temporary disability, pregnancy, breast/cervical cancer treatment
- Meet income and asset requirements
- Qualified immigrantà legal permanent resident
Benefits
- Inpatient Hospital Services
- Outpatiient Hospital Services
- Prentatal Care
- Lab and x-ray services
- Physician services
For More information about Medicaid or Medicare please visit:
Your local welfare office or apply online at www.compass.state.pa.us
Children’s Health Insurance Program (CHIP):
- Pennsylvania program to provide health insurance to all uninsured children and teens
Eligibility
- Based on income and family size: NO FAMILY MAKES TOO MUCH MONEY!
- Anyone can apply (some will get it for free, while others will get it at lower costs)
- Must not be eligible for Medical Assistance or have any other health insurance
- Must wait 6 months with no insurance for low cost or at cost CHIP
Benefits
- Immunizations
- Routine check-ups
- Prescription Drugs
- Dental care
- 90 days hospitalization/year
To Apply for CHIP please visit:
Http://www.chipcoverspakids.com or http://www.ibx.com
Or phone: 1800 986 KIDS ***THERE IS NO WAITING LIST****
Adult Basic:
- Program provides health insurance coverage to uninsured adults
Eligibility
- Must be between 19 and 64 years old
- PA resident
- Must be uninsured for 90 days prior to enrollment
- Must be U.S. Citizen or resident alien, or refugee
- Must not be covered by an insurance plan or eligible for Medical assistance
- Must meet family size and income guidelines
Benefits
- Doctor’s office visits
- Inpatient hospitalization
- Surgery
- Diagnostic tests and services
For more information about Adult Basic or to apply:
http://www.ibx.com index.jsp or http://www.ins.state.pa.us/ins/cwp
or Call: 1800 GOBASIC
Dental Insurance
It is important to visit your dentist regularly. Going to the dentist will help keep your teeth clean, prevent cavities, which can lead to dangerous infections, and prevent gingivitis.
Benefits
- Dental surgeries
- Hygiene and general care
To obtain affordable dental insurance plans please visit:
The Pennsylvania Dental Association http://www.padental.org
Available services for the insured or uninsured:
Clinic of Temple University Kornberg School of Dentistry www.temple.edu/dentisty or
CALL: 215-707-2900
Resources for the Uninsured:
There are health clinics available in 10 locations throughout Philadelphia
- Clinics are medical offices that provide free or low-cost services
Eligibility
- You will be billed on a sliding scale based on family size and income
Benefits/Services
- Medical check-ups
- Family planning
- Blood tests
- X-rays
- Dental Care
For More Information on Philadelphia Health Centers please visit:
www.phila.gov/health or Call 215-686-5000
Philadelphia Health Center 6
321 W. Girard Ave. 19123
Med: 215- 685-3803
Dental: 215-685-3816
CONTACT THE AACDC FOR MORE INFORMATION
This information was compiled by Christine Grywalski, BSN ’09, Villanova University, College of Nursing
|