Helping the Uninsured Find Health Care Coverage

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Nearly 30 percent of an estimated 45 million uninsured Americans are eligible for government–sponsored health coverage but are not aware of such programs or have difficulty reaching them.

The Foundation for Health Coverage Education, a non–profit 501(c)3 private organization based in San Jose, California, was founded several years ago in response to the increasing number of uninsured who qualify for health insurance but are not covered. Its mission is to provide effective health insurance eligibility information to assist people in obtaining health coverage through a comprehensive, state–by–state Coverage for All Program, whose Web site is www.coverageforall.org and consists of three major outreach tools:

U.S. Uninsured Help Line at 1–800–234–1317 is the keystone of the Coverage for All Program and is being rolled out nationally. It consolidates relevant health coverage program data on a state–by–state basis in one place for easy telephone access by people across the country.

The toll–free Help Line has live counselors and translators, providing guidance and answering questions in multiple languages, around the clock, seven days a week. They walk callers through a five–question eligibility test to locate financial benefits and help them select free or low–cost health benefits programs for which they may be eligible. The questions in the eligibility test refer to applicants’ current insurance status, the population category they are in, the number of members in their household, their monthly income, their age and their special health conditions.

After screening applicants, the call center helps consumers identify their potential options and guides them to obtain appropriate health coverage by referring them directly to appropriate state–sponsored programs and connecting them to health coverage representatives.

Handling thousands of calls each month, the Help Line has already been able to counsel many individuals and families who do not know what government programs they could benefit from and has helped them discover that they have more options than they initially thought. For instance, a family of four earning up to $50,000 a year may find out that they qualify for a Medicaid program offering health care coverage for children in some states.

Health Care Options Matrix is a free brochure particularly useful for front–line workers dealing with the uninsured such as social workers or health care professionals as well as for individuals who have access to the Internet. The Matrix can be viewed on the Coverage for All Program web site, downloaded and printed. It gives a comprehensive list of public programs in each state, providing information for the following programs and outlining the plan, coverage, eligibility and monthly cost for each:

Publicly sponsored coverage

  • Individuals unable to obtain private health insurance due to a medical condition
  • Low–income individuals and families
  • Children
  • Children enrolled in Medicaid or similar programs
  • Infants and children with developmental delays
  • Breast and cervical cancer screening
  • Veterans

Private health insurance coverage

  • Small business owners
  • Individuals recently covered by an employer health plan
  • Individuals and families

The Health Care Options Matrix has charts enabling individuals or social workers and health care professionals who assist them to assess their federal poverty level. It also shows how to investigate related issues such as laws and regulations, as well as ways to search for grants, loans or other benefits.

Health Coverage Eligibility Tool is also on the Coverage for All website and leads people through five simple, user–friendly questions about themselves and their household that can help them take advantage of options for medical coverage they did not know about. Individuals who can navigate the Internet on their own or with the assistance of front–line workers will receive a customized profile with all the public and private health plans for which they and their family members may qualify, a quick reference list of phone numbers and Web sites for all plans as well as a special resource section on locating financial benefits and free or low–cost health benefits.

Two other sources that could be helpful in finding health coverage are:

  • Government Benefits Finder at 1–800–FED–INFO
  • Catalog of Federal Domestic Assistance http://www.cfda.gov/

Philip Lebherz is the founder and executive director of the Foundation for Health Coverage Education and leader of the Coverage for All Program.

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