Low Cost Health Care Options
Overview
Summary
Residents of New York who are not eligible for public health insurance programs, such as Medicaid, Family Health Plus, Medicare, etc. or who are not covered by an employer-based or union health plan must find other ways to pay for health care. This chapter contains information on several resources for such individuals. These options include:
- Hospital Financial Assistance, also called charity care, is a system of hospital discounts available to low-income uninsured or underinsured New Yorkers.
- Health and Hospital Corporation (HHC) Options is the financial assistance program for hospitals and health centers that are part of the New York City Health and Hospitals Corporation.
- Prescription drug assistance, which include “indigent patient drug programs” available through the company that manufactures the drug.
- Community Health Centers (CHC) – clinics funded by the federal (and in some cases state or local) government that provide health services without regard to an individual’s ability to pay. Uninsured patients are billed on a sliding scale based on income.
- Low Cost Dental and Vision Care, which is offered in a variety of settings and each provider, has different eligibility and application rules.
- Options for the Self-Employed, some professional organizations offer access to group market coverage or to individual market coverage for the self-employed.
- Age 29 Dependent Law – Chapter 240 of the Laws of 2009, sometimes called the “Age 29” law may extend the age of dependency and permit eligible young adults through the age of 29 to remain on a parent’s health insurance coverage in the same manner as dependents who are children.
- NY Bridge Plan – the health care reform law created a temporary program until January 2014 that makes health coverage available for individuals who have a pre-existing medical condition.
- Emergency Room Medical Care – Federal and New York State law ensures that everyone, regardless of insurance status, ability to pay, or immigration status, has the right to emergency room medical care.
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Health Programs
- CHAMPVA
- Overview
- Description of Civilian Health And Medical Program
- Qualifying for Civilian Health And Medical Program
- Enrolling in the Civilian Health And Medical Program
- Recertifying for Civilian Health And Medical Program
- Documentation
- Cost Sharing And Claims Processing
- Advocacy And Appeals
- Government Contacts
- Additional Resources
- Source Materials
- Child Health Plus
- COBRA Continuation Coverage
- Overview
- Description of COBRA Continuation Coverage
- Qualifying for COBRA Continuation Coverage
- Applying for COBRA Continuation Coverage
- Maintaining COBRA Continuation Coverage
- Medicaid COBRA Program
- NYS Continuation Assistance Demonstration Program for the Entertainment Industry
- Temporary Federal COBRA Subsidy
- Advocacy And Appeals
- Government Contacts
- Additional Resources
- Source Materials
- EPIC
- Family Health Plus
- Overview
- Description of Family Health Plus
- Qualifying for Family Health Plus
- Applying for Family Health Plus
- Recertifying for Family Health Plus
- Documentation
- Managed Care Provisions
- Family Health Plus Premium Assistance Program
- Family Health Plus Employer Buy-in
- Advocacy And Appeals
- Government Contacts
- Additional Resources
- Source Materials
- Healthy NY
- HIV Uninsured Care Programs
- Low Cost Health Care Options
- Overview
- Hospital Financial Assistance – Charity Care
- Health And Hospital Corporation (HHC) Options
- Prescription Assistance
- Summary
- HHC Options Prescription Assistance
- Indigent Patient Drug Programs/Prescription Assistance Programs
- AIDS Drug Assistance Program (ADAP)
- Elderly Pharmaceutical Insurance Coverage Program (EPIC)
- Medicare Part D
- NY Prescription Saver
- New York State Department of Health Prescription Drug Price Website
- Wal-Mart $4 Prescription Program
- Nord's Medication Assistance Program
- Rx Outreach
- Mail Order Pharmacies
- Community Health Centers
- Low Cost Dental Care Options
- Low Cost Vision Care Options
- Options for Self-employed
- Dependent Coverage Through Age 29
- New York Bridge Plan
- Emergency Medical Services
- Government Contacts
- Additional Resources
- Source Materials
- Medicaid
- Overview
- Description of Medicaid
- Qualifying for Medicaid
- Budgeting Income
- Applying for Medicaid
- Summary
- Applicants' Rights and Responsibilities
- Automatic Eligibility
- Presumptive Eligibility
- Pickle Eligibility
- The Medicaid Application
- Filing the Application
- Application Requirements
- Processing Time
- Notice of Acceptance/Denial
- When Benefits Begin
- Retroactive Benefits
- Authorized Representatives
- Special Populations
- Recertifying for Medicaid
- Documentation
- Cost Containment Provisions
- Medicaid Managed Care Provisions
- Medicaid Spenddown Program
- Summary
- Description of the Medicaid Spenddown Program
- Medical Bills System
- Pay-In Program
- The Medicaid Card
- In-Patient Hospital Stays
- Expenses Paid By a Public Program
- Qualifying for the Medicaid Spenddown Program
- Applying for Medicaid Spenddown
- Recertifying for Medicaid Spenddown
- Choosing Between Spenddown and Family Health Plus/Child Health Plus
- Medicaid Home Care
- Home And Community Based Waiver Services
- Summary
- Care at Home for Children with Physical Disabilities - Levels I & II
- OMH Waiver for Children and Adolescents with Serious Emotional Disturbance
- Long Term Home Health Care (LTHHC) - Lombardi Program
- Traumatic Brain Injury (TBI) Waiver Program
- Office for People with Developmental Disabilities (OPWDD) Waiver
- Bridges to Health (B2H) Waiver
- Nursing Home Transition and Diversion Waiver (NHTD)
- Institutional Medicaid
- Additional Medicaid Benefits
- Advocacy And Appeals
- Government Contacts
- Additional Resources
- Source Materials
- Medicaid Buy-In
- Medicare
- Overview
- Description of Medicare
- Qualifying for Medicare
- Enrolling in Medicare
- Documentation
- Original Medicare: Cost Sharing and Claims Processing
- Managed Care: Medicare Advantage Plans
- Medicare Supplement Plans: MEDIGAP
- Medicare And Private Health Plans
- Advocacy And Appeals
- Government Contacts
- Additional Resources
- Source Materials
- Medicare Part D
- Overview
- Description of Medicare Part D
- Qualifying for Medicare Part D
- Enrolling in Medicare Part D
- Summary
- Enrolling In/Disenrolling From a Part D Prescription Drug Plan
- Initial Enrollment Period
- Annual Coordinated Election Period
- Medicare Advantage Disenrollment Period (MADP)
- Special Enrollment Period
- Enrollment for Special Populations
- Late Enrollment Issues
- How to Choose a Drug Plan
- Notice of Acceptance
- Recertifying for Medicare Part D
- Low-income Subsidy
- Advocacy And Appeals
- Government Contacts
- Additional Resources
- Source Materials
- Medicare Savings Program
- TRICARE
- VA Health Care

