Where can I find help getting insurance or financial support?
When it comes to your lupus treatment, choosing a health insurance plan you can depend on is important. If you are in need of insurance, there are a few different options to find coverage.
- Go to healthcare.gov/screener to see if you qualify for a special enrollment period on the health insurance marketplace. Typically, people can register for insurance on the marketplace between Nov 1 and Dec 15 (keep in mind that these dates may change slightly every year). Some people, however, will qualify for special circumstances that allow them to register outside of that period. With this tool you can determine whether you are eligible to apply right now, or if you can receive Medicaid.
- Check whether or not you are eligible for Medicaid enrollment. Medicaid is a state administered program, and each state sets its own guidelines regarding eligibility and services. The rules for counting your income and resources vary from state to state and from group to group. Visit the eligibility page on medicaid.gov to find out more information about Medicaid.
- Explore health care options off of the health insurance marketplace. An off-marketplace plan is a health insurance policy purchased directly from the carrier, outside of the market created by the Affordable Care Act (ACA). You can contact the health insurance carriers in your area to learn more about their individual plans. You can learn more about both types of plans in the ACA Open Enrollment Guide.
- If you are not eligible to apply for insurance now, you can go to healthcare.gov/get-coverage during open enrollment season, which is typically from November 1 to December 15. Look through the plan offerings and choose a plan option for residents of your state.
The majority of people that use healthcare.gov are eligible for some type of financial assistance:
- 9 out of 10 people who enrolled got financial assistance
- 3 out of 4 people currently enrolled can find plans for $50/month or less
Another helpful resource for medication assistance is GoodRx.com, which allows you to see the cost of medications at pharmacies near you. This website also shows the cash price as well as a discount price if you use a coupon found on their website.
You may also find this resource about financing medical care helpful. As mentioned in this video, you can also try reaching out to local hospitals to find out if there are any community programs in which you can enroll or if they are aware of any programs. Your local health department is also a good resource to find out about programs they have or community programs as well.
We hope that this information is helpful to you and that you will get the financial support you need. Please do not hesitate to contact us if you have any questions.
The Lupus Foundation of America and our health education specialists have answered some of your most common questions. The provided answers are for educational and information purposes only. Consult with your doctor/health care team for medical advice.
Our health education specialists are specially trained to provide people affected by lupus with non-medical support, disease education, information, and helpful resources. You have lupus, but you are not alone.