Government Payer
Children’s Health Insurance Program (CHIP) provides coverage to eligible children whose parents earn too much income to qualify for Medicaid, but not enough to pay for private coverage. It is best to check state guidelines to ensure eligibility.
Visit www.medicaid.gov/chip/index.html for more information.
Department of Defense TRICARE is the healthcare program available for active-duty members of our armed services and their family members, retirees, and retiree family members.
Visit www.tricare.mil/Plans for more information.
Indian Health Services (IHS) provides health services to American Indians and Alaska Natives who belong to federally recognized tribes within the United States.
Visit www.ihs.gov for more information.
Medicaid provides health coverage for eligible low-income individuals and is administered by states, according to federal requirements.
Visit www.medicaid.gov for more information.
Medicare is a government-funded insurance that provides healthcare coverage to individuals 65 years of age or older. People under 65 years of age may be eligible due to certain disabilities. Open enrollment for Medicare is from October 15 through December 7 each year. During this period, you can choose Original Medicare or add Medigap and choose or change a Part C or Part D plan.
There are four parts of Medicare:
- Medicare Part A is used for inpatient hospital stays, skilled nursing facility stays, hospice care, and home health care
- Medicare Part B is used for outpatient care and medical coverage including, but not limited to, doctor visits, lab tests, diagnostic services, and durable medical equipment
- Medicare Part C is private health insurance that is an alternative to Original Medicare
- Medicare Part D is the prescription drug plan for Medicare recipients
- Extra Help, or Low-Income Subsidy, is a program to help limited income individuals pay for prescription drug and program costs
- Limited Income NET (LINET) program provides temporary prescription drug coverage for low-income Medicare beneficiaries who have not yet enrolled in a Medicare Part D plan
- Medigap is private healthcare coverage offered by insurance companies to supplement Original Medicare.
Visit www.cms.gov for more information.
Veterans’ Health Administration (VA) provides health coverage to American veterans.
Visit www.va.gov/health for more information.
What is commercial or private insurance?
Commercial or private insurance plans may be purchased directly from an insurance carrier, insurance broker, Healthcare.gov, or through an employer group.
Once a year, during the designated open enrollment period, you may enroll in commercial or private insurance. You may be eligible for special enrollment if you have experienced a qualifying life event, examples include: recently becoming a citizen, moving to a new area, marriage, divorce, birth or adoption of a child, or losing your insurance coverage.
Visit www.healthcare.gov for more information.
How do I know what my coverage is?
Contact ASSIST via phone at 877-864-8437, via email by selecting the email option, or complete the Patient Authorization Form and forward to ASSIST. An ASSIST Specialist will be in contact to help navigate topics such as insurance coverage, prior authorization requirements, and in-network pharmacies.