H&W: Premium Assistance Under Medicaid and the Children’s Health Insurance Program

Professional Musicians & Employer’s Health & Welfare Fund:

If you or your children are eligible for Medicaid or the Children’s Health Insurance Program (CHIP) and you’re eligible for health coverage through your employer, your state may have a premium assistance program that can help pay for premium expenses, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov.

If you or your dependents are already enrolled in Medicaid or CHIP, you should contact your State Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office, dial 1-877-KIDS NOW or visit www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for enrollment of your eligible children in an employer-sponsored health plan.

If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible for enrollment under the rules of your employer provided plan (in our case, the Professional Musicians, Local 47, and Employers’ Health & Welfare Trust Fund), your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance by your State Medicaid Agency and/or CHIP.

For information about eligibility contact the California Department of Health and Human Services office online here.

To see which states have premium assistance programs or for more information on special enrollment rights, contact either:

U.S. Department of Labor
Employee Benefits Security Administration
www.dol.gov/agencies/ebsa
1-866-444-EBSA (3272)

U.S. Department of Health and Human Services
Centers for Medicare & Medicaid Services
www.cms.hhs.gov
1-877-267-2323, Menu Option 4, Ext. 61565

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