Medicaid, which provides coverage for low-income individuals and families, also sees a bump in enrollment in the fall, probably because of all the insurance advertising. But Medicaid sign-ups happen all year-round.
“People don’t know what they’re eligible for, especially if they’re lower income but not quite that low,” said Jessy Foster, an outreach and engagement specialist for Pennsylvania Health Access Network (PHAN), which helps people sign up for health insurance.
“Folks just hear more about it in the news and it’s being talked about, they’re just more likely to say, ‘Well, maybe I should find out,’” Foster said.
» READ MORE: How to sign up for insurance through healthcare.gov
Medicaid used to be restricted to low-income families and pregnant women. Under the Affordable Care Act, many states — including Pennsylvania and New Jersey — expanded eligibility to people with somewhat higher incomes, but many people may be unaware that they qualify.
In Pennsylvania and New Jersey, adults aged 64 and younger can qualify for Medicaid if their income is within 138% of the federal poverty level, meaning that they have an annual income of $16,753 or less in 2019.
Income limitations are higher for pregnant women and families with children.
You may also qualify for Medicaid if you are blind, or have a disability or a special medical assistance condition. Learn more about Medicaid eligibility requirements through your state’s Department of Human Services website.
» READ MORE: Looking for help with Medicare enrollment?
If you’ve been putting off figuring out insurance coverage, the ACA marketplace enrollment period, which runs through Dec. 15, is a good time to do it.
The federal marketplace website, HealthCare.gov, asks about your household income to determine whether you’re eligible for a premium tax credit and will direct you to enroll in Medicaid if the financial information you enter indicates you may be eligible.
Pennsylvania’s COMPASS website has a survey to help people determine whether they are eligible and complete an online application for Medicaid, as well as other services they may qualify for based on income.
PHAN’s Foster encouraged people who aren’t sure if they qualify or who feel overwhelmed by the application process to ask for help.
Organizations such as PHAN provide in-person assistance year-round. Each county in Pennsylvania has a medical assistance office that can answer questions and guide you through the process. You can find your local office through Pennsylvania’s Department of Human Services website, www.dhs.pa.gov. In New Jersey, turn to the Department of Human Services website, www.state.nj.us/humanservices, to find county-level board of social services for help.