Health Care: Government Financial Assistance Programs

For more information on help paying medical bills, visit FAQ: Health and Care: Financial Assistance for Paying Medical Bills
National
State Listings:   CT / IL / MA / NH / NJ / NY / NC / TX / VA / WA    (Official USPS State Abbreviations)

National

Centers for Medicare and Medicaid Services, previously the Health Care Financing Administration (HCFA), is a federal agency within the U.S. Department of Health and Human Services. CMS runs the Medicare program, Medicaid program, and State Children's Health Insurance Program (SCHIP). This website offers the latest information on each of these programs. See the Medicare website below for the official U.S. Government site for Medicare.

New sign Medicaid is the federal and state partnership that provides health coverage for selected categories of people with low incomes. Although the Federal government establishes general guidelines for the program, each state has its own rules and therefore Medicaid programs are different in each state. Your state might require you to pay a small part of the cost for some medical services. To be eligible for Medicaid, you may have to meet certain requirements involving your disability, income and assets, and U.S. and state citizenship. The type of benefit you may receive may be determined by the kind and amount of care you need. You can find information about Medicaid at the CMS link above. For eligibility, you must contact your state agency that carries out your state's Medicaid policy and program. To find your state Medicaid agency, visit Benefits.gov. Click on "Benefits." Select "Category." Click in the box labeled "Medicaid." Select the state in which you are a resident. Select search at the bottom of the page. You can then access links to the agency, benefits and eligibility for your state Medicaid program.

Medicaid Buy-in is designed to provide access to comprehensive health care for working people with disabilities. It allows working people with disabilities to pay a monthly premium to continue coverage in their state's Medicaid program, an affordable alternative to private health care coverage. Several states have already enacted this program, with many more planning to do so. Eligibility is determined by each individual state. The monthly premium is a sliding scale based on income. For more information call the Centers for Medicare and Medicaid Services at 800-MEDICARE (800-633-4227) or TTY/TDD 800-820-120.

Medicaid Home and Community Based Waiver Program provides states with the option to develop and implement creative alternatives to institutionalizing Medicaid-eligible individuals. This offers individuals the option to be cared for in their homes and communities, rather than nursing homes. Some of the services that may be provided without prior approval of the Federal government through this program include: Case Management Services, Homemaker Services, Home Health Aide Services, Personal Care Services, Adult Day Health Habilitation and Respite Care Services. Other services which may be provided with prior approval include: Transportation, In-Home Support, Meal Services, Special Communication, Minor Home Modifications, and Adult Day Care. Before applying for this program you may want to contact a case worker from a non-profit disability organization. A good place to start is your local Center for Independent Living.

New sign Medicare.gov is the Official U.S. Government Site for Medicare. Medicare is a health insurance program for people age 65 or older, people under age 65 with certain disabilities and people of all ages with End Stage Renal Disease. There is Part A Hospital Insurance, Part B Medical Insurance and Part D Prescription Drug Coverage. People with Medicare, family members and caregivers should visit this site for the latest enrollment, benefits and other helpful tools or call the Medicare Hotline at (800)-633-4227 or TTY/TDD (877)-486-2048.

U.S. Department of Health and Human Services via their Health Resources and Services Administration offers the Hill Burton Assistance Program is a federal program that provides free health care to those with income at or below the Health and Human Services Poverty Guidelines or reduced-cost care if your income is as much as two times (triple for nursing home care) the HHS Poverty Guidelines. This is not an all-inclusive insurance program; rather it is designed to cover costs associated with services other than routine doctor visits. You must apply to the Hill-Burton facility and each Hill-Burton facility chooses which services to offer for no or reduced charge. Eligibility is also based upon family size and income. The Hill Burton Assistance Program link above offers the steps to take to apply. For more information call the number below or visit the Hill Burton brochure . To find a hospital that provides care under this program, call (800) 638-0742 or visit Hill-Burton Facilities Obligated to Provide Free or Reduced-Cost Health Care listed by state.

What Happens When You Can't Pay Your Medical Bills?
By Jason Alderman, via the NFCC Financial Education Blog

State Listings

Connecticut

Connecticut Department of Social Services administers the SAGA and General Assistance Medical program, which provides medical assistance to low-income persons who do not qualify for, or who are awaiting an eligibility determination, for other state or federal medical assistance programs. Eligibility is based on income and assets only. For more information, call (800) 842-2159.

Illinois

Illinois Department of Human Services offers the Home-Based Support Services Program, which tailors services to help adults with eligible disabilities live at home. The program pays for services to help enrolled adults (age 18 or older) become more independent living on their own or with their families. Participating adults are entitled to services worth approximately $17,000 to $19,000 per year. They also offer the Family Assistance Program, which pays a monthly cash stipend to help with the costs of caring for an eligible child (age 17 or younger) with a severe mental disability. Participating families receive approximately $5,000 to $7,000 yearly.

Funds are typically appropriated for the program during the spring session of the General Assembly. If funding is sufficient to allow enrollment of additional persons, new persons are selected by a random drawing during the summer. If such a drawing is held in a given year, families and individuals whose applications are received by May 31 of that year are eligible for the random drawing. To learn more, call (800) 843-6154, ext. 3.

Massachusetts

Massachusetts Division of Medical Assistance manages MassHealth, a program that pays for health care coverage for eligible low to moderate income Massachusetts residents who are under the age of 65. MassHealth covers an extensive list of services including outpatient hospital visits, pharmacy services, physician services, personal care services, dental services and much more. For more information, call (800) 841-2900 or (800) 497-4648 (TTY).

New Hampshire

Medicaid for Employed Adults with Disabilities (MEAD) is a new Medicaid coverage group that allows adults with disabilities to work and earn wages without losing their Medicaid coverage. In general the program makes a person with a significant disability who is employed eligible for Medicaid by removing the poverty requirements of the regular Medicaid rules. Net income must not exceed 450% of the federal poverty level and resources may not exceed $20,000 for a single person or $30,000 for a household of two. For more information, contact the New Hampshire Department of Health and Human Services by phone at (800) 852-3345 ext. 4796 or (800) 735-2964 (TDD) 8:00 - 4:30 M-F.

New Jersey

State of New Jersey Health Link Financial Assistance page offers a comprehensive list of programs that offer financial assistance or reduced fees for health-related services in New Jersey including community care programs and health centers, family care services, special child health services and more.

New York

Family Health Plus (FHP), is no onger available by the New York State Department of Health, because of changes under the Affordable Care Act. Starting January 1, 2014, New York individuals should apply for health insurance coverage through the Marketplace; https://nystateofhealth.ny.gov/

North Carolina

North Carolina Division of Medical Assistance manages Medicaid and NC Health Choice for Children for the state of North Carolina. Medicaid is a health insurance program for certain low-income and needy people paid with federal, state, and county dollars. Medicaid covers children, the aged, blind, and/or disabled, and people who are eligible to receive federally assisted income maintenance payments. Under the Medicaid Program is the Community Alternatives Program for Disabled Adults which provides home care services as an alternative to institutionalization. For more information, call (919) 857-4011.

Texas

Your Texas Benefits allows individuals to self-screen for potential eligibility for assistance programs provided by the Texas Department of Human Services. STARS screens for medical assistance programs for children and families, the Children with Special Health Care Needs (CSHCN) program, the Community Care for Aged and Disabled (CCAD) program, the Nursing Facility Community Based Alternatives (CBA) program, Medicare and Medicaid, and many others. Visit this website to learn of your eligibility.

Texas Department of Human Services provides direct grant benefits to individuals with physical disabilities to purchase services that enable them to live in the community via their In-home and Family Support Services Program. The program offers assistance for the purchase or lease of special equipment or architectural home modifications to facilitate care, treatment therapy, or general living conditions of a person with a disability. The program also offers assistance for expenses related to medical, surgical, therapeutic, diagnostic, and other health services related to a person's disability, counseling and training programs that help provide proper care of an individual with a disability, respite care, attendant care, home health services, home health aide services, homemaker services and chore services that provide assistance with training, routine body functions, dressing, preparing and consuming food, and ambulating. For more information, call (888) 834-7406(Voice) (888) 425-6889 (TDD).

Virginia

Virginia Department of Medical Assistance Services offers a variety of comprehensive health services to Virginians. Services include an Uninsured Medical Catastrophe program for those under 300% of the poverty level, prescription assistance programs, as well as the State/Local Hospitalization Program (SLH), which is a cooperative effort between the state and local governments that is designed to provide coverage for inpatient and outpatient hospital care, care in approved ambulatory surgical centers and care provided in local health departments. For more information on these and other programs, visit their website or call (804) 786-4231 (Voice), (800) 343-0634 (TDD).

Washington

Washington Health Care Authority administers Basic Health, a state-sponsored program that provides health care coverage to low-income Washington residents who do not qualify for Medicare. Monthly premiums, as low as $10, are based upon family size, income, age and the selected health plan. Basic Health covers hospitalization, provider visits, emergency services, prescriptions, and many other benefits. Co-payments may apply. For more information, call (800) 826-2444.

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