Once you have seen a doctor, filling needed prescriptions is the next challenge. There are many resources available to help you:
The Comprehensive Health Insurance Program provides health care coverage for people with conditions that render them uninsurable in the private market and for whom no other health insurance option is available. The Illinois Comprehensive Health Insurance Plan (CHIP) is a program established and maintained by the State of Illinois to provide health insurance coverage for residents of Illinois who, due to the existence or history of a medical condition, are unable to acquire coverage through private insurance, an HMO or an employer sponsored group health plan. CHIP is not an insurance company. It is subject to its own enabling Act, and is neither an entitlement nor a welfare program. Based on the amount of state money that is available to subsidize this insurance program, the Board of Directors of CHIP is required to close or limit enrollment in the Traditional CHIP pool in order to ensure there are sufficient resources to meet obligations to existing participants.
Medicaid is a state operated healthcare program for persons who are aged (65 and older), blind or disabled. It provides medical coverage for doctor visits, prescription drugs, hospital care, emergency room coverage, long term care, durable medical equipment and a variety of other healthcare services.
Medicare is the Federally sponsored Health Insurance Program for people 65 years of age and older, some people under 65 years of age who receive Social Security Disability benefits, and people with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant). There are 3 basic plans through Medicare: Part A which provides hospital insurance, and Part B which provides general medical insurance (office visits, labs, limited medication, etc), Part C is a managed care type of plan and blends Parts A, B and sometimes D into one plan, and Part D which provides prescription coverage.
All Kids is Illinois’ program for children who need comprehensive, affordable health insurance, regardless of family income, immigration status or health condition. All Kids covers doctor visits, hospital stays, prescription drugs, vision care, dental care and eyeglasses, regular check-ups and immunizations (shots). All Kids also covers special services like medical equipment, speech therapy and physical therapy for children who need them. All states offer children health coverage similar to All Kids. If you want more information about programs available outside of Illinois you can click HERE
FamilyCare offers healthcare coverage to parents living with their children 18 years old or younger. FamilyCare also covers relatives who are caring for children in place of their parents.
Attached are both the pre-health reform and the projected post health reform patchwork quilts. This is necessarily an over-simplification of a very complex set of programs, so it cannot account for every contingency and obscure set of circumstances.
In addition to the popular patchwork quilt tool is a new patchwork quilt the identifies the levels of medical coverage available under Medicare, Medicaid, HBWD, Illinois Cares Rx and Medicare Medigap policies.
Illinois Cares Rx is a State Prescription Drug Assistance Program. Illinois Cares Rx helps persons 65 and older or persons with disabilities meet prescription costs regardless of Medicare status.
This program provides health coverage for employed persons with disabilities by permitting employed persons with disabilities to purchase Medicaid coverage by paying a monthly premium.
Illinois Veterans' Care
Veterans Care Program is designed to provide comprehensive, affordable healthcare to Illinois' uninsured veterans and covers those veterans who have the least access to reliable healthcare. These are the veterans who cannot currently access Veterans Health Administration's benefits and who meet specific income requirements. Premiums or $40 or $70 are charged based on the eligible veteran’s income.
Illinois Warrior Assistance Program
The Illinois Warrior Assistance Program provides assistance for Illinois Veterans as they transition back to their everyday lives after serving our country and is focused on helping service members and their families deal with the emotional and psychological challenges they may be facing.
The Veterans Administration provides health care for veterans in a variety of circumstances, particularly those who are poor and those with disabilities connected with their military service. The VA operates a nationwide network of hospitals, clinics, residences and other facilities. It also provides an assortment of other services needed by veterans, including education, housing, income supports, etc.
Who is eligible?
The type of discharge from the military can be a factor. It is not an issue if you received:- An honorable discharge
- A general discharge
- A discharge under honorable conditions
- Former enlisted persons who started active duty before September 8, 1980, or
- Former officers who first entered active duty before October 17, 1981
- Were a reservist who was called to Active Duty and who completed the term for which you were called, and who was granted an other than dishonorable discharge, or
- Were a National Guard member who was called to Active Duty by federal executive order, and who completed the term for which you were called, and who was granted an other than dishonorable discharge, or
- Only request a benefit for or in connection with:
- a service-connected condition or disability; or
- treatment and/or counseling of sexual trauma that occurred while on active military service; or
- treatment of conditions related to ionizing radiation; or
- head or neck cancer related to nose or throat radium treatment while in the military.
- Were discharged or released from active duty for a hardship , or
- Were discharged with an “early out”; or
- Were discharged or released from active duty for a disability that began in the service or got worse because of the service; or
- Have been determined by VA to have compensable service-connected conditions; or
- Were discharged for a reason other than disability, but you had a medical condition at the time that was disabling, and in the opinion of a doctor, would have justified a discharge for disability (in this last case, the disability must be documented in service records)
Where to apply?
- Priority Group 1 Veterans with service-connected disabilities rated 50% or more disabling
- Priority Group 2 Veterans with service-connected disabilities rated 30% or 40% disabling
- Priority Group 3 Veterans who are former POWs, veterans whose discharge was for a disability that was incurred or aggravated in the line of duty, veterans with service-connected disabilities rated 10% or 20%, disabling veterans awarded special eligibility classification under Title 38, U.S.C., Section 1151, "Benefits for individuals disabled by treatment or vocational rehabilitation"
- Priority Group 4 Veterans who are receiving aid and attendance or housebound benefits veterans who have been determined by VA to be catastrophically disabled
- Priority Group 5 Non-service connected veterans and service connected veterans rated 0% disabled whose annual income and net worth are below the established dollar threshold
- Priority Group 6 All other eligible veterans who are not required to make co-payments for their care including:
- World War I and Mexican Border War veterans
- Veterans receiving care solely for disabilities resulting from exposure to toxic substances, radiation or for disorders associated with service in the Gulf War; or for any illness associated with service in combat in a war after the Gulf War or during a period of hostility after November 11, 1998
- Compensable 0% service-connected veterans
- Priority Group 7 Non-service connected veterans and non-compensable 0% service-connected veterans whose needed care cannot be provided by enrolling in any of the groups above and who agree to pay specified co-payment.
- Priority Group 8 (8e and 8g have been closed to enrollment since 2003) Veterans with income and/or net worth above the VA national income threshold and the geographic income threshold who agree to pay co-pays.
- Subpriority a: Noncompensable 0% service-connected veterans enrolled as of January 16, 2003, and who have remained enrolled since that date
- Subpriority c: Nonservice-connected veterans enrolled as of January 16, 2003, and who have remained enrolled since that date
- Subpriority e: Noncompensable 0% service-connected veterans applying for enrollment after January 16, 2003
- Subpriority g: Nonservice-connected veterans applying for enrollment after January 16, 2003
- If not sure if you qualify under this category check out the VA's Enrollment Calculator
What happens after you apply?
TRICARE
TRICARE is available to active duty service members and retirees of the seven uniformed services, their family members (and some eligible former spouses), survivors and others who are registered in the Defense Enrollment Eligibility Reporting System (DEERS). TRICARE is also available to members of the National Guard and Reserves and their families. Benefits will vary depending on the sponsor's military status. You must be registered in DEERS and have a valid uniformed services identification card showing you are eligible for TRICARE.
Who is eligible?
Active duty service members are automatically enrolled. All other persons need to actively enroll in the program. Some persons who may be able to be enrolled are:
- Spouses and unmarried children of active duty service members
- Service retirees, their spouses, and unmarried children
- Medal of Honor (MOH) recipients and/or their families.
- Un-remarried former spouse and unmarried children of active duty or retired service members who have died
- Spouses and unmarried children of reservists and National Guard who are ordered to active duty for more than 30 consecutive days (they are covered only during the reservist’s active duty tour) or of reservists and National Guard who die on active duty.
- Unmarried children up to age 21 (including stepchildren who are adopted by the sponsor)
- Certain family members of active duty service members who were court-martialed and separated for spouse or child abuse. The victims of the abuse within the family are eligible for health benefits for the period that the abused family member is receiving “transitional compensation” under Section 1059 of Title 10, U.S. Code.
- Former spouses of active, retired or former military members may be eligible for TRICARE if they meet the following requirements:
- Must not have remarried. (If remarried, the loss of benefits remains applicable even if the remarriage ends in death or divorce.)
- Must not be covered by an employer-sponsored health plan.
- Must not be the former spouse of a North Atlantic Treaty Organization or Partners for Peace nation member.
Since the above is not all inclusive nor a detailed list, it is recommended that you review eligibility at the TRICARE website.
How do you apply/enroll?
The person who is in military service or is a retiree (called the sponsor) has to complete the enrollment. If you believe you should be enrolled, but the military service member is not fulfilling his/her obligation, you may need to contact their commanding officer, if still in active duty. If you're unsure about your eligibility for TRICARE benefits, contact the Defense Manpower Data Center Support Office (DSO) to check your eligibility status by calling toll-free, 1-800-538-9552.
To obtain health coverage from the state or federal programs you have to fit specific criteria, such as being 65 or older, blind, disabled, a child under 19, a related adult who cares for a child under 19, or pregnant. Often you also have to be a US citizen or legally admitted into the US.