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Finding Coverage & Care without Health Insurance

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Know Your Options

Explore the health insurance options below to see what works best for you.

This guide to health insurance was created by MS Navigators on the Benefits & Employment Support Team.  We have taken care to include every possible insurance solution we are aware of – if you need help navigating this page please contact us.

Comparing Health Plan Options and Prescription Help for People with MS gives you questions to think about as you compare options. If you have access to detailed coverage and cost information about a potential health insurance plan, you may use this Health Insurance Checklist to estimate and compare your annual cost for each plan that is available to you.
 
If you’ve exhausted the suggestions on this list and still can’t get health insurance, take a look at our resources for finding care without health insurance.

1. Start Here

First, see if you’re eligible for any of these types of coverage:  

2. Still Need Coverage?

If you’ve looked at the first set of health insurance options and still need coverage, explore whether any of the following types of coverage are available:
 

Start By Reviewing these Types of Coverage

First, see if you’re eligible for any of these types of coverage.  

Current Employer for self/spouse/partner

Are you or your spouse or domestic partner employed? Employer-based coverage can be more affordable than other options, and if you have access to this type of plan it may be your best bet. Ask your employer(s) if you can enroll in their health plan

MS Navigator Tips:
  • If you’ve lost coverage or had life changes in the past 30 days, you may be eligible for a Special Enrollment Period.
  • If you have access to employer coverage (through yourself or a spouse) that meets the government’s definition of affordable, you will NOT be eligible for cost help for a Marketplace plan.
Learn more on the Society's job-based health insurance page.
 
For more information about your eligibility, contact Human Resources.

Young Adult (25 and under)

Are you under the age of 26?  You may be able to enroll in your parent’s health insurance policy
 
MS Navigator Tip: This can generally be elected only during the employer’s general enrollment period or if there’s a Special Enrollment Period that applies because of lost coverage or life changes in the past 30 days.

Learn more on the Society's job-based health insurance page.
 
For more information about your eligibility, contact Human Resources.

Active Duty or Veteran

Are you a veteran?  You may be able to get VA benefits or other veterans health coverage.

Learn More: For support with your application, contact Disabled American Veterans or Paralyzed Veterans of America.

Medicare

Are you 65 or older or have you had Social Security Disability Insurance benefits for 24 months? You may be eligible for Medicare
 
MS Navigator Tip: MS Navigators on the Benefits & Employment Support Team will be happy to help you learn about your new Medicare benefits when you get your red, white, and blue card. 
 
Learn more on the Society's Medicare page.
 
For help understanding your benefits and eligibility: Contact an MS Navigator for personalized benefits counseling or find a local SHIP Counselor.

Less Common Options

You may have options not listed here.  If you think you may be entitled to coverage through a former employer or other entity (such as Indian Health Services), contact the benefits administrator.
 
For more information about eligibility, contact your former employer or benefits administrator.   If you worked for the federal government, contact Office of Personnel Management.  If you are American Indian or Alaskan Native, contact IHS.  Military benefits may be available through Tricare.
 
 

Still Need Coverage?

If you’ve looked at the insurance options above and still need coverage, explore whether any of the following types of coverage are available:

Marketplace

Contact the Assisters at your state’s marketplace (1-800-318-2596) to find out if it is open enrollment or if you are eligible for a Special Enrollment Period. Applications can be done by phone, with a paper application, online or in person with an assister. Find local help on healthcare.gov.

MS Navigator Tip: We recommend contacting local help to make sure you understand the plan options that may meet your needs and all the cost help that may be available to you. MS Navigators can provide local help resources for you but are not trained Marketplace Assisters. To get the one-on-one support you need, contact your Local Help providers.
 
Learn more on the Society's Individual Health Insurance page.
 
For more information about your eligibility contact your state’s marketplace or find local help.

Expansion Medicaid

Many states expanded Medicaid coverage to all low-income adults after the Affordable Care Act was passed.  Ask the Assisters at your state’s marketplace (1-800-318-2596) if members of your family are eligible for Medicaid or the Children’s Health Insurance Program (CHIP).   Applications can be done by phone, with a paper application, online or in person with an assister.  Find local, in-person help on healthcare.gov.
 
MS Navigator Tip: Many states did not expand Medicaid eligibility to all low-income adults. Learn more and find the status of your state here.

Learn More: For more information about your eligibility contact your state’s marketplace or find local help.

Traditional Medicaid

Even if you are not eligible for Expansion Medicaid, you might still be eligible for one of the many types of Medicaid available in your state.  These programs are generally available to those who have low household incomes and health concerns (such as disability, blindness, or pregnancy).  Call your local Medicaid office and ask for a full review of your eligibility for all programs they offer.
 
Learn More: Contact your local Medicaid office to find out if you are eligible for any of their health insurance programs.

COBRA Continuation Coverage (lost employer coverage recently)

Did you lose employer-based coverage in the past 60 days?  You may be able to enroll in COBRA to extend the benefits you received through your former employer.
 
MS Navigator Tips: Learn More:  For information about costs and your eligibility for COBRA, contact Human Resources or your Benefits Administrator.
   

Haven't Found the Right Option?

If you still need coverage, the following coverage types may be available but be aware that they may have higher costs and incomplete benefits:

Off-Marketplace Plans

These plans may meet the requirements of the health care law, including covering pre-existing conditions, providing free preventive care, and not putting limits on annual benefits, and may be purchased outside of the Marketplace Open Enrollment.
 
MS Navigator Tip: Tax credits that lower the cost of marketplace plans for eligible individuals are not available for plans purchased outside of the marketplace. 
 
Learn more on Healthcare.gov's Private Plans page.
 
Contact your State Department of Insurance for information about health insurance agencies or brokers who are authorized to sell plans in your state.

Student Plans

Some colleges or universities offer student health insurance plans.  These plans generally offer limited benefits and should be purchased only when no other options are available, after careful review of the costs, coverage, and limits.
 
Learn more on the Centers for Medicare & Medicaid Services' Student Health Plans page.

Contact your college or university to learn what health insurance may be available to you.

Alternative Coverage Options (Junk Plans)

Alternatives to individual health insurance plans (such as short-term plans, association health plans and health care sharing ministries) are becoming increasingly common and will likely continue to grow. These alternative coverage arrangements are marketed to individuals as more affordable options with low upfront costs. These plans typically only offer extremely limited coverage and are considered high risk for people with pre-existing conditions.
 
MS Navigator Tips:
  • Buyer Beware – these plans often have low premiums because their coverage is so limited.
  • Alternative coverage options do not comply with many Affordable Care Act requirements.  Without state action to regulate these coverage arrangements, consumers will face higher premiums, fewer plan options, and a loss of consumer protections.
The National MS Society does not offer resources for these plans. Read the Society's news item on Short Term Health Insurance Plans.    

Finding Care without Health Insurance

  • Find local neurologists here. Some may offer lower cost services to uninsured individuals, but if this isn’t included in the comments you will have to call their offices directly to find out if this is available. We encourage you to check with your current neurologist’s office about this option as well. Programs that help may be called sliding fee, charity care or indigent care. 
  • The Multiple Sclerosis Foundation offers a healthcare assistance grant for uninsured individuals. Apply online or call them at 888-673-6287.
  • If you cannot find a local neurologist who can see you at lower cost, a health center may be an option.  Locate health centers in your area; keep in mind that they generally do not offer neurology services but may have general practitioners who may prescribe MS medications and may be able to facilitate referrals to specialists.
  • View programs that help with the cost of MS therapies.  To find programs that pay for your other prescription medications, please check NeedyMeds.   
  • If you need an MRI while you are uninsured, the MS Association of America’s MRI Access Fund may help.  This program assists with the cost of brain MRIs and can reimburse for MRIs in some situations.   
  • If you need emergency care while uninsured, a Safety Net Hospital may be able to provide you with free or lower-cost care.  

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