KEY:
MFA = Medicare for All**
IHS = Indian Health Service
Medicaid = availability depends on income, status* and state
CHIP = Children’s Health Insurance Plan*
Tricare = insurance for military families
VA = Veteran’s Administration
Enhanced Medicare = available to those 65 years of age and over and those with disabilities who qualify. Cap on deductible is $1,500/yr ($0 for inpatient), Cap on Rx is $305/yr, Covers 80% dental, hearing and vision. Two year wait for Medicare disability benefits is waived.
Medicare Advantage = a private health insurance plan through the Medicare system
Transition Medicare Buy In = includes Medicare Advantage Plans (have to include drug benefits – MA-PD Plan), available to those who meet the age requirement, pay monthly premium. No dependents.
FEHBP = Federal Employee Health Benefits Plan
Private insurance (PHI) = as an employee, on the health exchanges* or as a dependent
Public option = called a Medicare Transition Plan (MTP), only available to those who are eligible to purchase health insurance on the Health Exchange, equivalent to a Platinum Plan.*
If you don’t qualify for any of the above, you are uninsured.
*Residents with citizenship or permanent legal status only.
** Covers “all residents” but leaves the definition of residents up to the Secretary of Health, so it may not include undocumented immigrants.
| Age in years | Year 1 | Year 2 | Year 3 | Year 4 |
| 0-18 | Eligible for MFA or can stay in IHS, Medicaid, CHIP, FEHBP, Tricare, PHI or MTP. * | Same | Same | All in MFA (those covered by IHS can continue to use that system). |
| 19-34 | Choices based on eligibility are IHS, VA, Medicaid, FEHBP, Tricare, PHI or MTP. * | Same | Same | All in MFA (those covered by IHS or VA can continue to use that system). |
| 35-44 | Choices based on eligibility are IHS, VA, Medicaid, FEHBP, Tricare, PHI or MTP. * | Same | Same and also eligible for Transition Medicare Buy-in. | All in MFA (those covered by IHS or VA can continue to use that system). |
| 45-54 | Choices based on eligibility are IHS, VA, Medicaid, FEBHP, Tricare, PHI or MTP.* | Same and also eligible for Transition Medicare Buy-in. | Same and also eligible for Transition Medicare Buy-in. | All in MFA (those covered by IHS or VA can continue to use that system). |
| 55-64 | Choices based on eligibility are IHS, VA, Medicaid, FEBHP, Tricare, PHI, MTP and Transition Medicare Buy-in.* | Same. | Same. | All in MFA (those covered by IHS or VA can continue to use that system). |
| 65 and up | Enhanced Medicare or Medicare Advantage. | Enhanced Medicare or Medicare Advantage. | Enhanced Medicare or Medicare Advantage. | All in MFA (those covered by IHS or VA can continue to use that system). |
