3/7/2023
Having health coverage is a basic requirement in any country where you live or will be visiting. Due to its importance and the fact that many are unaware of the alternatives available, we want to show you how to get health insurance in the United States.
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Basics to get health insurance in the USA
Our health can fail us and you never know when something can go wrong. Especially in the United States, you don't want to be in a situation that prevents you from getting proper medical care. To know how you can get health insurance, you need to understand a few concepts first:
Health insurance marketplace
In the USA there is what is known as the Affordable Care Act. This regulation allows individuals and families to get health coverage regardless of their medical history and income.
The Health Insurance Marketplace gives you the opportunity to find and compare the different policies available in terms of health care, drug discounts, types of services and more.
Health Insurance Marketplace eligibility requirements
Even if you already have some sort of coverage, anyone can belong to the health insurance marketplace to review what alternatives they can take advantage of.
To get health insurance through this system, you need to:
- Reside in the United States and not be in jail.
- Have U.S. citizenship, permanent residency (green card) or have some legal justification to be in the country.
Although the enrollment period has a deadline, there is the possibility of obtaining a deferment through the SEP (Special Enrollment Period).
There are several circumstances that give you this extension: expired coverage, getting married, moving, adopting, or having a baby. Depending on the event, you may have 60 days before or after to join a plan. In programs like CHIP or Medicare, enrollment is open year-round.
How to enroll in the health insurance marketplace
If you meet the minimum requirements outlined above, you have 2 options to join the system:
- Creating an online account from the healthcare.gov website.
- Downloading, printing and filling out the CMS form to apply for coverage and then mailing it to the appropriate address.
Low-cost health care
In the event that you have limited resources to purchase health insurance in the United States, there are other cheaper ways:
- Medicaid. This is a combined state and federal program that provides financial support to those with little money.
- Medicare. This health policy is available to those who are over 65, suffer from end-stage renal disease or have a disability under certain eligibility conditions.
- Uninsured health care. There are the so-called Health Resources and Services Administration (HRSA) health centers. There you are cared for and pay what you can afford based on your finances.
- Charity Care. Another government program for people with very few resources that subsidizes all or part of the medical care received.
How to get private health insurance
According to the U.S. Census, the majority (about 180 million) of U.S. citizens have a private health insurance policy. This coverage comes from companies that are not part of the federal government.
When it comes to enrolling in one of these plans, you have 2 choices:
- Use a licensed agent.
- Get health insurance through your employer.
There are some health insurance plans that offer you the minimum benefits that meet the requirements of Obamacare (Affordable Care Act). In addition, there are others that may not qualify as a health plan under the law, such as catastrophic coverage and short-term policies.
Types of private health insurance
One of the differences between private and public coverage has to do with the types of policies that are available. In this regard, you will find several plans:
- Short-term coverage when you are between plans.
- Personalized selection through an insurer.
- Catastrophic coverage for those who qualify.
- Linkage to a joint plan through an employer.
What is COBRA?
This type of health insurance comes from the Consolidated Omnibus Budget Reconciliation Act. This legislation allows you and your family to continue health coverage when you were employed and for a stipulated period of time in the event you lose your job.
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Requirements for COBRA
You only have to meet 3 conditions to get this extension:
- You have to be a qualified beneficiary.
- The group plan offered to you by your company must be under the Cobra umbrella.
- There are certain situations that allow you to appeal to this resource: dismissal or resignation from your job, reduction of working hours, change of job, divorce or death.
Knowing how to get health insurance in the United States is not so complicated if you meet the minimum requirements and know what your best options are.
Español: ¿Cómo obtener un seguro médico en Estados Unidos?