There are several health care programs that are available to low-income and uninsured people. Some are reduced cost and some are government programs are that are free. Each government program has its own eligibility and income guidelines that must be met. Even if you don't qualify for insurance, you probably can get help especially if you need medical attention that will involve costly care.

COBRA
COBRA, or the Consolidated Omnibus Budget Reconciliation Act, allows workers terminated from their job for any reason other than "gross misconduct" to continue individual or family health care coverage under their former employer's group plan for up to 18 months. The worker's spouse and dependent children are eligible for COBRA coverage in the event of the worker's death, a divorce, legal separation, or a child's loss of eligibility for dependent care coverage under the plan rules.

You should be notified of your right to continue coverage by your insurance plan administrator within six weeks of termination of your right to continue coverage. It is up to the employee or the family to notify the insurance plan administrator within 60 days of divorce, separation or other reasons other than loss of the job. Generally, this is a very expensive option as employer group plans are usually very costly. It may be your best option if you or a family member has a pre-existing medical condition when your employment ends. You have 60 days to decide if you want to continue the health plan at the full cost.

Blue Cross Special Care

Philadelphia (215) 568-8204
Outside of Philadelphia 1 (800) 453-2566

This is a reduced cost managed care program offered by Blue Cross and Blue Shield. You can also contact other insurance providers if you want and can afford regular cost individual coverage. Visit Web site.

Services:

• Hospital care- 21 days inpatient per 90 day period
• 4 doctor visits per year with $10 co-pay
• Outpatient diagnostic tests up to $1,000 per year
• Emergency room care
• Maternity care
• Gynecological care
• No prescription drugs

Pennsylvania Adult Basic Coverage
In June 2001, Governor Tom Ridge signed into law the Health Investment Insurance Act (Act 77 of 2001). Act 77 is a dramatic initiative that invests the proceeds of the state's tobacco settlement in the health of Pennsylvania consumers. The state is expected to receive approximately $11 billion over the course of 25 years.

The largest single component of the settlement will provide health insurance to a number of uninsured Pennsylvanians between the ages of 19 and 64. The program will provide health insurance for adults meeting certain income requirements and who do not have health care coverage.

This new program -adultBasic- is administered by the Pennsylvania Insurance Department and offers basic benefits, including, preventive care, physician services, diagnosis and treatment of illness or injury, in-patient hospitalization, out-patient hospital services and emergency accident and medical care.

Eligibility Requirements

Participation in the adultBasic Program is based on certain eligibility requirements, which include:

• Having no other health care coverage (including Medicaid or Medicare)
• Lack of prior coverage under any other insurance plan for 90 days prior to enrollment; except for a person (and their spouse) who has been laid off his/her job
• Are ages 19 through 64
• Having family income below 200 percent of the Federal Income Guideline (see table below)
• Having lived in Pennsylvania for at least 90 days prior to enrollment; and
• U.S. citizenship or a permanent legal alien status

The following chart explains the number of people in the family versus the maximum income in order to be eligible for the program:

Benefit Package

The adult insurance program is designed to provide basic insurance benefits, including:

• Hospitalization (unlimited days)
• Physician Services (primary care and specialists)
• Emergency Services
• Diagnostic Tests (e.g. X-rays, mammograms and laboratory tests)
• Maternity care
• Rehabilitation and skilled care (in lieu of extended hospitalization)

Modest co-pays for certain benefits are required. They are:

Doctor Visit- $5.00
Emergency Room-$25.00 (waived if admission occurs)
Specialists - $10.00

How can I enroll?

Applications for enrollment in the adultBasic Program are available from adultBasic contractors or by calling toll-free number
1-800-G0-BASIC. On-line application is also available. See "Application for adultBasic" or reference www.compass.state.pa.us.
For more information about the program visit the Insurance Department of Pennsylvania's Web site.
(information on PA's Adult Basic Program obtained from PA Insurance Department Web site)