Health Care Assistance Guide

Health Care Assistance Guide

Travis County: Low Income, No Medicaid, No Medicare, No Insurance

Travis County residents who are not covered by Medicare or Medicaid or private insurance can access healthcare and a variety of services through Central Health.

Eligibility is limited to Travis County residents. To determine eligibity and apply for the Medical Access Program (MAP), visit the Central Health website or call 512-978-8130.

Individuals will need:

  • Proof of Travis County residency
  • Proof of US citizenship
  • Picture ID
  • Proof that you are the legal guardian of any child in your household
  • Proof of any other health care benefits that you have been approved, denied or have a pending application
  • Proof of household income and other forms if requested

Note: Enrollment in MAP is not tied to the Federal Government’s ‘public charge’ regulations and therefore, any eligible enrollee should not fear of impact to a green card.

Austin Public Health

Austin Public Health (APH) is a part of the City of Austin and is tasked with promoting a healthy community for Austinites, to prevent illness, injury and disease and to protect the commuity fom infectious diseases, environmental hazards and epidemics. (512.972-5000, 7201 Levander Loop, Bldg. E, Austin 78792)

APH provides immunizations, shelter, food, clothing, job assistance, blood pressue, diabetes and STD screenings including HIV/AIDs, hepatitis and tuberculosis screenings.

In addition, APH offers nutritional support through the WIC program (Women, Infants, Children), birth and death certificates, inspection of restaurants and outreach and education on topics such as smoking cessation, mother friendly workplaces and injury prevention.

Medicaid and the Children’s Health Insurance Program (CHIP)

Medicaid is a federal government insurance partnership between the federal government and each state. Therefore, eligibility and benefits can differ from state to state.  In Texas, Medicaid, and CHIP (Children’s Health Insurance Program) provide health coverage for low income children, families, seniors, and people with disabilities.

To determine Medicaid and CHIP eligibility:

Once approved for eligibility in Medicaid or CHIP, individuals then select a health plan.

  • STAR is a program for children, newborns, pregnant women, and some families.
  • STAR+PLUS is a program for adults with a disability, people age 65 and older, and women with breast or cervical cancer.
  • STAR Kids is a program for children and adults age 20 and younger with a disability.
  • CHIP is a program for children and unborn children in families that earn too much money to qualify for Medicaid but cannot afford private insurance.

Medicare

Medicare is federal health insurance for people 65 or older or, for younger individuals with disabilities, End Stage Renal Disease (ESRD), or ALS (Lou Gehrig’s disease)

If an individual is eligible for both Medicare and for Medicaid, there are Medicare Advantage plans for these ‘dual eligible’ individuals to join if they are avaialble in their area. Eligibility will require that a dual eligible individual live in the service area of the Medicare Advantage plan (this is also true for those over who are not disabled or diagnosed with ESRD or ALS—all Medicare Advantage enrollees must live within the service are of the Advantage plan).

To enroll in a Medicare Advantage Plan, a Dual Medicare Advantage plan, or a Medicare Supplemental Plan, one must be enrolled in Medicare Part A and Part B.

All individuals who have worked full time in the US for a minimum of 10 years (or 40 quarters) earn Medicare Part A free of charge. Medicare Part A provides for hospital (usually inpatient care) coverage. Enrollment in Part A of Medicare is automatic for most at age 65.

Part B provides for ‘medical insurance; (usually outpatient care) and has an associated cost based on an individuals’ past income. One can enroll in Part B by visiting a local Social Security office or by calling Social Security at 1-800-772-1213.

When an individual is enrolled in Part A and B, they can choose to elect a Medicare Advantage plan to cover the cost sharing that Medicare does not cover (Medicare provides 80% coverage leaving individuals with a 20% cost share). Individuals may also elect to enroll in Medicare Supplemental plan to cover the cost sharing not covered by Medicare.

To enroll in Medicare Advantage plan, an individual may seek out an Insurance Agent or call Medicare  1-800 Medicare or visit  www.medicare.gov to see available plans. Medicare representatives can enroll an individual in a Medicare Advantage plan.

Purchasing Private Health Insurance

For those who are not eligible for Medicaid, Medicare or have access to health insurance through their employer, they may purchase an individual policy through the government at www.healthcare.gov.

If a person has a ‘life event’, such as losing their current health plan or losing eligibility to Medicaid or they turn 26 and fall off of their parent’s plan, they can enroll in an ACA plan immediately.

If not, the annual open enrollment for the ACA Exchange is November 1 through December 15 with coverage effective on January 1 of the following year. The site helps users to determine if they are eligible for financial subsidies as well.

Phone: 1-800-318-2596

Healthcare options for the contiguous counties of Hays and Williamson

Hays County

Williamson County

Central Texas Mental Health Services

Need someone to talk with? Contact us.