Advocacy

Health Insurance Programs

The Asthma and Allergy Foundation of America has several resources on health insurance topics that affect those with asthma and allergies:

Children’s Health Insurance Program (CHIP)

The Children’s Health Insurance Program (CHIP) is a state administered health insurance program that provides health coverage to eligible children through Medicaid and separate CHIP programs. CHIP provides health insurance for children up to age 19 in low to moderate income families with incomes that are too high to qualify for Medicaid. In some states, CHIP also covers parents and pregnant women. Learn more about CHIP’s State Program information.1

Routine checkups and dental visits are free of charge under CHIP, but there may be copayments for others services. Some states charge a monthly premium for CHIP coverage. Although states differ on the price for CHIP coverage, families won’t have to pay more than 5 percent of their income. You may enroll in Medicaid and CHIP programs at any time during the year. See if you qualify and/or to enroll in Medicaid or CHIP.

Consolidated Omnibus Budget Reconciliation Act (COBRA)

The Consolidated Omnibus Budget Reconciliation Act (COBRA) health benefit provisions require group health plans to provide a temporary continuation of group health coverage that otherwise might be terminated. COBRA requires continuation coverage to be offered to covered employees, their spouses, former spouses and dependent children. It is often more expensive than the amount that active employees are required to pay for group health coverage.

If you become eligible to elect COBRA when you would lose group health coverage, you should consider all of your options before making a decision. It may be more affordable for you and your family through other group health coverage, such the Health Insurance Marketplace or Medicaid. Learn more about COBRA . 2

Medicaid

Medicaid is a health care program for individuals and families with low incomes and limited resources. Medicaid is administered by the states according to federal rules and regulations. States are required to cover certain “mandatory benefits” and can choose to provider other “optional benefits” through their Medicaid program. Before the ACA, Medicaid coverage was generally denied to individuals without dependent children under the age of 65, but now states may extend Medicaid benefits to individuals without dependent children that live below the poverty level (each state specifies how far below the poverty level). Contact your state Medicaid program to find out how you can apply .

Medicare

Medicare is a federal program which provides health insurance for people over the age of 65, those under the age of 65 with certain disabilities and people with end-stage renal disease. The different sections of Medicare cover different services:

Learn more about Medicare and how to apply for coverage . 3

To Learn More

Affordable Care Act

The Affordable Care Act makes it easy for individuals to purchase health insurance plans through the Health Insurance Marketplace at affordable rates.

https://www.healthcare.gov/get-coverage/

CHIP

Children’s Health Insurance Program is state-administered health insurance program that provides health coverage to eligible children through Medicaid and separate CHIP programs.

https://www.healthcare.gov/medicaid-chip/childrens-health-insurance-program/

COBRA

The Consolidated Omnibus Budget Reconciliation Act health benefit provisions require group health plans to provide a temporary continuation of group health coverage that otherwise might be terminated.

https://www.healthcare.gov/unemployed/cobra-coverage/

Health Marketplace

Through this program created by the ACA, individuals can now compare and purchase affordable health insurance.

https://www.healthcare.gov/quick-guide/

Medicaid

This is a health care program for individuals and families with low incomes and limited resources

http://medicaid.gov/    

Medicare

This is a health insurance program for people over the age of 65, younger people with disabilities, and people with end-stage renal disease.

http://www.medicare.gov/your-medicare-costs/help-paying-costs/medicaid/medicaid.html

Veteran’s Health Administration (VA)

If you served in the active military, naval or air service and are separated under any condition other than dishonorable, you may qualify for VA health care benefits.   

http://www.va.gov/healthbenefits/

Asthma, Allergies and Insurance

If you are told a prescription is not on your insurance company or health plan/program formulary (a list of drugs that your insurance company covers), you can talk to your doctor about alternative medications.

Questions you may need or want to ask your insurance provider or health plan/program:

  • “Are asthma or allergy medications a covered benefit for my children and me?”
  • “How can I get a referral to a doctor that specializes in asthma and/or allergies?"
  • “How often can I get prescription refills?”

More Information

 

 

Tell Congress not to repeal the Patient Protection and Affordable Care Act until there is a better bill that protects pre-existing conditions and those on Medicaid.

 

References

[1] Medicaid.gov. Children’s Health Insurance Program. http://medicaid.gov/chip/chip-program-information.html

[2] United States Department of Labor. Health Plan and Benefits: COBRA. http://www.dol.gov/dol/topic/health-plans/cobra.htm

[3] Medicare.gov. http://www.medicare.gov/