Health Insurance and Benefits

What it is

Getting coverage and help — Medicaid, the insurance marketplace, food benefits, and disability support.

Why it helps you

Coverage turns scary bills into manageable ones. Many people qualify for free help and never know it.

Good to have first

Offices and Paperwork (helpful).

This opens up

Affordable care across this whole Area.

Where to get help

Rules changed in 2025 and 2026

A federal law signed in July 2025 changed Medicaid, food benefits (SNAP), and Marketplace insurance. Some changes have already started. Others start in 2027. The steps below can help you keep your benefits. A free helper can tell you what applies in your state.

Free help applying

Find Local Help (HealthCare.gov) Trained “assisters” (also called navigators) help you apply for Medicaid or a Marketplace plan. They are free and don’t earn money from insurance companies.

• Cost: Free.
• Who can use it: Anyone who needs help getting health coverage.
• How to start: Enter your ZIP code to set up help in person, by phone, or by email. Or call 1-800-318-2596 (TTY 1-855-889-4325), open 24 hours a day.
• Good to know: “Agents” and “brokers” are also listed. They are licensed, but they are usually paid by insurance companies. An assister is the neutral choice.

Your state Medicaid office (Medicaid.gov) Medicaid is free or very low-cost health coverage for people with low income. Each state runs its own program. This page links to yours.

• Cost: Free to apply. Most care is free or has a small copay.
• Who can use it: Depends on your state, income, and situation. In many states, most adults with low income can qualify.
• How to start: Click your state to find the phone number and how to apply. You can apply any time of year.
• Good to know: You’ll need to prove who you are, your income, and your citizenship or immigration status. If you have no income, ask how to say so in writing.

Health insurance you buy

HealthCare.gov (the Health Insurance Marketplace) The government website where you can compare and buy health plans. Many people get help paying the monthly cost, based on income.

• Cost: Depends on your income and plan.
• Who can use it: US citizens, nationals, and people lawfully present in the US. Help with costs depends on your income and whether you can get other coverage.
• How to start: You can sign up from November 1 to January 15 each year. Outside that time, you need a life change, like losing other coverage, moving, or having a baby.
• Good to know: Help with monthly costs got smaller for many people starting in 2026. Don’t count on a $0 plan. Check real prices, or ask an assister. Some states run their own website with different dates.

Food

SNAP state directory (USDA) SNAP (once called food stamps) puts money for groceries on a card each month. Each state runs it. This map links to your state’s office.

• Cost: Free.
• Who can use it: People with low income. Your state decides who qualifies.
• How to start: Click your state and apply online, by phone, or in person.
• Good to know: If you have almost no money, ask for expedited (fast) SNAP. If your monthly income is under $150 and you have $100 or less in cash and bank accounts, you can get food money within 7 days. There are other ways to qualify too, like if your rent and utilities cost more than your income and cash. You must prove who you are first. Some other papers can wait.

USDA National Hunger Hotline Staff help you find food near you today and tell you how to reach your state’s SNAP office.

• Cost: Free.
• Who can use it: Anyone who needs food.
• How to start: Call 1-866-348-6479 (1-866-3-HUNGRY), or 1-877-842-6273 for Spanish. Open Mon–Fri, 8 a.m.–8 p.m. Eastern.
• Good to know: You can also text SNAP or FOOD to 914-342-7744 for automatic answers. Nobody reads or answers the texts.

Disability benefits

Social Security disability (SSI and SSDI) Monthly payments for people whose health stops them from working. SSI is for people with little income and few things they own. SSDI is for people who have worked enough years.

• Cost: Free to apply.
• Who can use it: People with a disability or blindness (or 65 and older, for SSI) who meet the rules. Mental health conditions can count.
• How to start: Start at ssa.gov, or call 1-800-772-1213 (Mon–Fri, 8 a.m.–7 p.m. local time; TTY 1-800-325-0778).
• Good to know: You’ll need medical records showing how your condition limits you. Many first applications are turned down. You can appeal, and free legal aid can help.

If you’re denied or cut off

LawHelp.org A directory of free nonprofit legal aid offices in every state. They can help you appeal a Medicaid, SNAP, or disability decision.

• Cost: Free.
• Who can use it: People with low income. Each office has its own rules.
• How to start: Pick your state, then call the legal aid office listed for benefits problems.
• Good to know: Appeals have short deadlines. Call as soon as you get a letter saying no, or saying your benefits will stop.

What the new rules mean for you

Medicaid work rules. If you are 19 to 64 and got Medicaid because your state “expanded” it, you may need to show 80 hours a month of work, volunteering, job training, or half-time school. Earning about $580 a month can also count. States must start by January 1, 2027, and some may start sooner.

Many people are excused. This includes people who are pregnant or just had a baby, people with a disability or serious health condition, parents or caregivers of a child 13 or younger or of someone with a disability, people in drug or alcohol treatment, former foster youth under 26, and American Indians and Alaska Natives. Ask your state if you fit.

Medicaid renewals. Starting in 2027, many adults on Medicaid will have to renew every 6 months, not once a year.

SNAP work rules. If you are 18 to 64, able to work, and have no child under 14 at home, you may need to work or train 80 hours a month. If not, you can get SNAP for only 3 months in 3 years. Being homeless, a veteran, or a former foster youth no longer excuses you by itself. Some areas have exceptions, so ask your SNAP office.

What you can do:

• Open every letter from Medicaid and SNAP right away. Many people lose benefits just from a missed letter.
• Keep your address and phone number up to date with the office.
• Keep proof of your hours: pay stubs, a signed note from where you volunteer, or school papers.
• Renew on time, every time.
• If you get a notice, answer it fast. For Medicaid work rules, you get 30 days to show you qualify. If you lose coverage, you can apply again.

Privacy if you’re on a parent’s or spouse’s plan

You can stay on a parent’s health plan until age 26. But the plan often mails papers about your care, like an “Explanation of Benefits,” to the person who holds the plan. Under federal privacy law (HIPAA), you can ask the plan in writing to send your mail somewhere else. If you say that sharing could put you in danger, the plan must agree to a reasonable request. It can’t question your reason. Some states protect you even more. A clinic or legal aid office can help you ask.

If you only do one thing first

Call 1-800-318-2596 or use Find Local Help to set up a free meeting with an assister. Tell them your income, even if it’s zero. They can check if you qualify for Medicaid, help you apply, and point you to food help. You don’t have to figure this out alone.

Watch out for

• Anyone who charges to apply. Medicaid, Marketplace plans, SNAP, and Social Security are free to apply for. A fee means a scam.
• Brokers who push one plan. Some people who sell plans are paid by insurance companies. Ask an assister to look at your choices, too.
• “Short-term” plans. These cheap plans are not full insurance. They may not pay for care for health problems you already have, mental health, or pregnancy.
• Texts asking for your EBT PIN. Your state will never text you a link asking for your PIN or Social Security number. Don’t click. Call your state’s EBT number instead.
• Ignoring mail. A missed renewal or work-hours notice can end your coverage. Open every letter.

Insurance words, in plain English

Definitions follow HealthCare.gov’s glossary.

• Premium: What you pay for your plan every month, even if you don’t go to the doctor.
• Deductible: What you pay for covered care each year before your plan starts to pay. With a $2,000 deductible, you pay the first $2,000.
• Copay: A set amount, like $20, you pay for a visit or medicine.
• Coinsurance: A percent of the cost you pay, like 20%.
• Out-of-pocket maximum: The most you’ll pay for covered care in a year. After that, the plan pays the rest.
• Network: The doctors, hospitals, and pharmacies your plan has a deal with. In-network care costs you less. Out-of-network care can cost much more, or not be covered.
• HMO: A plan that usually covers only doctors in its network, except in an emergency.
• PPO: A plan where in-network doctors cost less, but you can see others for more money.
• EPO: A plan that covers only in-network doctors, except in an emergency.
• High-deductible plan (HDHP): Lower monthly cost, but you pay more yourself before the plan pays. It can be paired with an HSA.
• HSA (Health Savings Account): A savings account for health costs, with tax breaks. You need a high-deductible plan to put money in. The money stays yours year after year, even if you change jobs.
• FSA (Flexible Spending Account): A work benefit that lets you set aside money for health costs before taxes. Money you don’t use by the deadline is usually lost, though some jobs let you keep a small amount or give you extra time.