Pennsylvania adultBasic
The adultBasic program expands health coverage for low-income adults that do not qualify for Medicaid or Medicare. Children are ineligible, because they are already covered through CHIP. adultBasic makes special provisions for those who lose their jobs.
The eligibility requirements for the unemployed are straightforward:
- You must have been a legal PA citizen for at least 90 days
- You must have no other health care coverage options
- You must be ineligible for Medicaid/ Medicare
- You must be between the ages of 19-64
- You must meet the income requirements
Income Requirements
Your household cannot earn more than a certain level of gross annual income, which varies with the number of family members. For a family of four, this is $42,400. One aim of the program is to specifically address the unemployed population, so it is unlikely that your unemployment benefits will surpass this income threshold.
How It Works
The State of Pennsylvania won $11 billion from Tobacco companies in 2001, to be paid out over the course of 25 years. It invested those monies in health care expansion for under-served populations. You can apply online by clicking here.
Benefits
Pre-existing conditions are not covered. Beyond that, the program aims to provide basic coverage:
- Physician visits
- Specialist visits
- Inpatient and outpatient hospital services
- Emergency care
- Maternity care
- X-rays and laboratory
- Rehabilitation and therapeutic care
As a basic coverage plan, the following are not covered:
- Ambulence
- Dental
- Vision
Cost
The highly-subsidized monthly premium is $30 per month. In addition, most treatments require a modest copay at the time of service. These copays range from $5-25.
In Conclusion
This plan is largely paid for by the Tobacco companies. Although coverage is basic, the monthly premiums are a fraction of what coverage would cost in the private marketplace.
