People with MS can overcome common problems in getting and keeping health insurance by understanding their sources of protection should their coverage end or change. This section provides information and resources to help you understand the rights and responsibilities of health plan beneficiaries, how to file appeals and maximize benefits and how to navigate Medicare and its drug plans.
Getting and Keeping Health Insurance
Two Important Insurance Acts
Two federal laws known as Consolidated Omnibus Budget Reconciliation Act (COBRA) and the Health Insurance Portability and Accountability Act (HIPAA) are specially designed to help individuals maintain their group coverage and continue their eligibility for health insurance after certain life circumstances.
Medicaid is a program that can make it possible for you to get the care that you need so that you can get healthy and stay healthy - even if you can't afford health care. It is available only to certain low-income individuals and families who fit into an eligibility group that is recognized by federal and state law. Medicaid does not pay money to you. It sends payments directly to your health care providers. Depending on your state's rules, you may also be asked to pay a copay for some medical services.
Medicaid is a state-administered program and each state sets its own guidelines regarding eligibility and services. Find out more about Medicaid in your state:
Medical Assistance for Workers with Disabilities (MAWD)
MAWD is a state-run program for people with disabilities in Pennsylvania between the ages of 16 and 65. Unlike other medical assistance programs, the program allows monthly income of up to $2,168 for single people or $2,917 for couples. To receive MAWD, you must be involved with some type of work every month, but there is no minimum or maximum work amount required. Learn more.
If you believe the service, device, treatment or medication in question should have been covered by your plan, you can and should appeal (PDF). Many people do not pursue their appeal rights because they don't believe they can win. But if you are dissatisfied with the outcome of a claim for any reason, you have nothing to lose by taking advantage of your right to request a reconsideration of the original claim. Learn more.