Healthcare in America: Overview

America has a patchwork quilt of healthcare, which depends on age, income, employment and demographic. You have access to affordable health care if:

  • You are 65 or older (Medicare).
  • You work for an employer who provides group health insurance.
  • You recently worked for an employer who provided group health coverage, and you can afford to pay for COBRA continuation coverage (which allows you to continue the coverage for 18 months by paying the employee’s share and the employer’s share of the monthly health premium—often costing over $2000 per month for a family).
  • You are low-income and qualify for Affordable Care Act (Obamacare) subsidies to purchase health insurance on a state exchange or the national exchange;
  • You are at, or below the Federal Poverty Level and qualify for Medicaid in your State as a covered cohort and you can find a provider nearby who accepts Medicaid’s relatively low provider payments;
  • You live in a Medicaid expansion State and have income near, at, or below the Federal Poverty Level;
  • You are aged, blind, or disabled, and your income is less than 75% of the Federal Poverty Level (Medicaid);
  • You are a child in a low-income family that earns too much for Medicaid but is poor enough to qualify for the State’s CHIP program (Children’s Health Insurance Program);
  • You are active duty military, a military retiree, or an immediate family member of a military person (TRICARE coverage);
  • You are a veteran in a “high-priority” group (i.e., service-connected disability and/or low-income) (Veterans Health Administration);
  • You are a dependent or survivor of a veteran permanently and totally disabled from a service-connected condition (CHAMPVA).
  • You cannot work due to a disability (after two years on Social Security Disability Insurance, you are entitled to Medicare coverage).
  • You are an American Indian or an Alaskan Native and live near an Indian Health Service facility.