Public Insurance Programs
Over 27% of Americans benefit directly from public healthcare programs set up by the government. The majority of citizens do not receive their healthcare through a government program, and most of the uninsured do not qualify for these programs, but those who are covered include children, the elderly, veterans, the disabled, and some of the poor. Here is a summary of the main four programs, but remember that smaller, local programs may also exist in your area.
Medicaid
Medicaid is a public health program that covers low-income people who meet certain criteria (thought to be around 40% of the poor population). It is run at state level, funded by both the government and individual states. Citizens applying for Medicaid coverage are means tested to determine eligibility, but simply being in poverty does not necessarily meet these requirements. Eligibility is determined through examining high medical bills, checking whether the citizen receives other government financial aid, and other monetary considerations. People with certain disabilities, many pregnant women, and children are also eligible, and much Medicaid coverage goes into nursing homes to treat the elderly.
Medicare
Medicare is primarily focused on providing coverage for citizens aged 65 years and over, but also covers some people in special circumstances, like the disabled. When applying for coverage, you are asked whether you have other means of insurance that would come into play before Medicare, such as coverage through an employer, family member, or workers’ compensation. The eligibility criteria can be complicated, and Medicare offers an online, dynamic eligibility tool which asks relevant questions depending on the answers you give. A general guideline is that if you are over 65 and receive Social Security retirement benefits, and your employer was covered by Medicare, you may receive part of their coverage without needing to pay premiums.
Veterans Health Administration
The Veterans Administration (VA) aims to provide healthcare to veterans and their families. At times of war, the demand for rehab, mental care, and nursing home beds increases. The VA uses a system to place veterans into eight main priority groups and further subgroups. Factors influencing these allocations include income of the patient, their assets, and disabilities sustained as a result of service. If the veteran is found to have a major service-connected disability, such as post-traumatic stress disorder or loss of a limb, they are given care and any necessary medication for free. Those patients judged to have lesser qualifying factors, and higher incomes, are required to make copayments toward healthcare which is not service-related. Nursing home care and dental care is typically more limited.
State Children's Health Insurance Program (SCHIP)
SCHIP covers low-income children and pregnant women who are not eligible for Medicaid. This program aims to address the problem of families whose income is too high to qualify for Medicaid, but is still so modest that they cannot afford other health insurance options. The programs are run on state-level but with federal guidelines. SCHIP has been expanded to cover a further 4 million citizens, including legal immigrants, following the Children's Health Insurance Reauthorization Act of 2009.