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Ask Ms. Medicare

Younger Spouse Losing Health Insurance, Now What?

Health coverage options when too young for Medicare

State high-risk pools: Thirty-five state governments currently run programs that offer health insurance to people who have difficulty buying or affording individual insurance because of preexisting medical conditions. Costs and benefits vary greatly from state to state, but, on the whole, this insurance tends to be more expensive than individually-purchased plans. Only a few states offer special rates for people with lower incomes. To see whether your state has a high-risk pool, go to the list provided by the National Association of State Comprehensive Health Insurance Plans.

Federal high-risk pool: This program, introduced in 2010 under the Affordable Care Act, the new health care law, guarantees coverage to people who are otherwise uninsurable because of health problems. Officially known as the Pre-Existing Conditions Insurance Plan (PCIP), it is available in all states. However, to qualify you must have been without any health insurance for six months before applying. For details about PCIP in your state, go to the government website that explains the program.

Medicaid: Under the current law, state medical assistance programs for people with low incomes are available to people under age 65 who have disabilities, are pregnant or are younger than age 19. Go to this list for links to state Medicaid websites. These sites include information on the state Children's Health Insurance Programs (SCHIPs), which offer coverage to otherwise uninsured children.

Free and low-cost community health clinics: You may be able to get medical treatment from a local clinic that provides health care for free or at a low cost, depending on your income. To find contact information for any clinics that might be available in your area, go to the U.S. Health Resources and Services Administration's online directory or to the NeedyMeds website.

More help starting 2014: Younger spouses facing loss of coverage will have more and better options in 2014, when the main provisions of the Affordable Care Act go into effect. If the law is implemented as written, you will then be able to go through a state insurance exchange to find private coverage that comes with federal protections. These protections include being able to buy individual insurance regardless of health or preexisting conditions, annual caps on out-of-pocket expenses, and subsidies on premiums for people with low or middle incomes. The law also greatly expands eligibility for Medicaid to adults under age 65. For more information, go to the government website that explains the law's provisions.

Also of interest: Everything you need to know about Medicare.

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