Insurance for Low Income & Health Problems

Finding health insurance with a pre-existing health condition can mean high monthly premiums, coverage restrictions and even insurance policy refusals. Individuals and families with low incomes may struggle to find affordable health insurance without the help of government programs designed to assist low-income Americans and those with health conditions in finding quality coverage.

Medicaid

• The federal Medicaid program was established in the 1960s to promote quality health care to Americans who couldn't afford it. Today, Medicaid continues that purpose, with each state's program offering little to no patient cost-sharing, as well as an array of health benefits that include physician's care, hospital services, ambulatory transfers, diagnostic testing and emergency services. Because the program is both federally and state-funded, many states also provide extended services to Medicaid enrollees as well.

Eligibility Groups

• Though the federal government does not require any U.S. state to offer Medicaid, it does require those that choose to participate to provide coverage to certain eligibility groups. Regardless of what state you live in, Medicaid always includes benefits for children, parents of children and pregnant women with household incomes that meet state eligibility guidelines. The federal government also requires all participating states to provide Medicaid to individuals deemed medically needy.

Pre-Existing Conditions

• In 2010, the federal government and several U.S. states began organizing pre-existing condition insurance pools, or PCIPs, in accordance with the Affordable Care Act. States that do not organize their own PCIP must participate in the federal PCIP instead. If your income is not low enough to qualify for Medicaid in your state, you may instead qualify to purchase private health insurance through your PCIP if you have an existing medical condition for which you have previously been denied health insurance coverage. You must, however, pay your own health insurance premiums if you qualify, but premium amounts depend on the insurance plan you choose and your age, rather than your health or medical history. All insurance plans in government PCIPs offer comprehensive health benefits without exclusions or waiting periods.

Future Changes

• The state and federal PCIPs will not be around forever. Instead, they are only temporarily available until January 2014, when the Affordable Care Act will make all health insurance companies and policies compliant with the standards of the PCIPs. At that time, no one will receive coverage denials or discriminatory insurance rates due to health conditions, and there will be no waiting periods or exclusions from the date of coverage.