What are my options?


 

There are many health care services and programs available to you and your family, whether you have health insurance or not.  Many of them are free or low-cost, depending on your income.

 

Health Insurance Options -- Health insurance can be confusing, complicated and difficult to understand. The Pennsylvania Insurance Department has put together a list of resources to help answer questions and help citizens to understand coverage. A list of consumer publications, resources and hyperlinks can be found at http://www.portal.state.pa.us/portal/server.pt/community/health_insurance/9189 .

 

Pennsylvania Fair Care -- PA Fair Care is Pennsylvania’s health plan for adults with pre-existing conditions who have been uninsured for six months. This temporary plan offers transitional insurance coverage until the broader coverage provisions of federal health insurance reform come to fruition in January 2014. Individuals who are eligible will have a monthly premium of $283, plus copays and coinsurance. Go to www.pafaircare.com for more information.

 

Licensed Private Insurance Companies -- The Insurance Department’s Web site, www.insurance.pa.gov, offers information and updates on licensed private insurance companies in Pennsylvania. For a list of these companies, go to http://www.insurance.state.pa.us/dsf/gfsearch.html . This information may also be requested by calling the Department’s automated Consumer Hotline at 1-877-881-6388.

 

Health Care Reform -- On March 23, 2010, President Barack Obama signed The Patient Protection and Affordable Care Act (PPACA; P.L. 111-148) into law. One week later, he signed the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152), which made numerous changes to PPACA. The health care reforms in these laws aim to expand coverage to millions of Americans and will require a large number of changes to health insurance products and the regulations that govern them.  For more information, visit www.insurance.pa.gov and click on the red “Health Care Reform &You” button.

 

Community Health Centers -- There are approximately 170 community health centers across the state that provide free or low-cost comprehensive, high quality medical health care for all ages on an ability-to-pay basis. In some locations, a full range of services such as dental care and prescription drugs may be available. Services may be free or low-cost, based on your household income. To find the health centers nearest you, call the PA Association of Community Health Centers, Monday to Friday, 8:30 am to 5:00 pm, at 1-866-944-CARE (2273), or go to http://www.pachc.com/health_find.html for a list of Pennsylvania health centers.


Medical Assistance (MA) -- If your circumstances change (for example, if you become disabled, turn 65, or become pregnant) or your income decreases, you may qualify for MA. To learn more, go to www.compass.state.pa.us and click on “Do I Qualify?” to find out if you may be eligible for MA.  Remember, you may always re-apply for MA.

 

Financial Assistance with Hospital Bills – Most hospitals offer financial assistance for uninsured patients who need treatment but cannot afford to pay their bills.  Patients who qualify will have their bills reduced or eliminated. If you have hospital bills that you cannot afford to pay, call the hospital’s billing department and ask how you may apply for financial assistance.

 

Medical Assistance for Workers with Disabilities (MAWD) -- MAWD is a health insurance program for working individuals with a disability. There is no set requirement for how many hours you must work or how much you must earn, but you must work and receive wages to qualify. For more information, call 1-800-692-7462 or go to www.dpw.state.pa.us , type in “MAWD” in the Site Search box in the top right corner, then click on the first link to “Medical Assistance Benefits for Workers with Disabilities”.

 

Pharmacy Assistance  - Pennsylvania residents who do not participate in any other state or federally funded prescription program may be able to receive free or low-cost prescriptions.  If you have a prescription discount card, you may still qualify. Call 1-800-955-0989 for The Pennsylvania Patient Assistance Program Clearinghouse or go to www.aging.state.pa.us , “Prescription Assistance” and “Other Pharmaceutical Programs”.  The Clearinghouse will help you apply for free or low-cost prescription medicines available from drug manufacturing companies and other sources.

 

Dental Care -- Free or low-cost dental care may be provided by a dentist or clinic in your area. Go to www.padental.org and choose “Patients” for a dental clinic directory and other informational resources.

 

Mental Health Treatment/Drug or Alcohol Abuse Treatment -- Individuals and families can receive mental health, drug or alcohol treatment at a location close to home.  Services may be free or low-cost, depending on your household income. Click here for mental health services call 1‑800-692-7462. Click here for substance abuse services or call 1-800-692-7462.

 

SelectPlan for Women – Pennsylvania’s SelectPlan for Women is a free, confidential health care program for women between the ages of 18 and 44 that pays for family planning services and related preventive health screens provided by participating health care professionals. Family planning-related prescriptions are free at any participating pharmacy. For more information and to see if you are eligible, call 1-800-842-2020 or go to www.selectplanforwomen.com.

 

HealthyWoman Breast and Cervical Screening Program (HWP) -- HWP offers breast and cervical exams at no cost for eligible women. These exams include mammograms, clinical breast exams, pelvic exams and Pap tests. You qualify if you are 40 to 64 years old; have no or limited insurance; and have low to moderate household income.  For more information and to find the HWP check-up site near you, call 1-800-215-7494 or go to www.pahealthywoman.org.

 

Breast and Cervical Cancer Prevention and Treatment Program (BCCPT) -- If you have been diagnosed with breast or cervical cancer or a pre-cancerous condition of the breast or cervix, you may be eligible for free care through BCCPT.  The care covers your breast or cervical cancer treatment, as well as any other unrelated conditions while receiving your cancer treatment.  You qualify if you are female; under age 65; meet the income requirements; and have no or limited insurance. For more information, call 1‑800-842-2020 or click here for more information.

 

Pregnancy/High-Risk Pregnancy (Healthy Beginnings/Healthy Beginnings Plus) -- If you are pregnant, you may be eligible for Healthy Beginnings or Healthy Beginnings Plus – free programs that provide comprehensive health care coverage to pregnant women and their babies for a full year. Call 1-800-842-2020 for more information on how to apply and for locations near you or click here for more information.

 

Special Pharmaceutical Benefits (HIV/AIDS and Schizophrenia) -- If you have been diagnosed with HIV/AIDS or schizophrenia, this confidential program helps pay for specific drug therapies used in your treatment. Call 1‑800-922-9384 or click here for more information.

 

Children’s Health Insurance Program (CHIP) -- Pennsylvania offers high quality, comprehensive free or low-cost health care coverage for every child up to age 19, who is not eligible for Medical Assistance.  There are three easy ways to apply: online at www.chipcoverspakids.com; over the phone by calling

1-800-986-KIDS (5437); or download a paper application at www.chipcoverspakids.com.

 

Children with Special Health Care Needs -- If your child has a special health care need or a chronic condition, s/he may qualify for Medical Assistance and/or other services, regardless of your household income.  Please call the Special Kids Network at 1-800-986-4550 or click here for more information.