If you are eligible for health coverage from your employer, but are unable to afford the premiums, some
States have premium assistance programs that can help pay for coverage. These States use funds from
their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premiums.
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below,
you can 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, you can contact your State Medicaid or
CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify,
you can ask the State if it has a program that might help you pay the premiums for an employer sponsored plan.
Once it is determined that you or your dependents are eligible for premium assistance under Medicaid
or CHIP, your employer’s health plan is required to permit you and your dependents to enroll in the
plan – as long as you and your dependents are eligible, but not already enrolled in the employer’s plan.
This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance.
New York, Massachusetts, and California are among the states that may offer assistance for paying employer health plan premiums. You should contact your State for further information on eligibility.
NEW YORK – Medicaid CALIFORNIA – Medicaid MASSACHUSETTS Medicaid & CHIP
Phone: 1-800-541-2831 Phone: 1-866-298-8443 Phone: 1-800-462-1120
To find out more information about premium assistance programs, or for more information on special
enrollment rights, you can contact either the U.S. Department of Labor Employee Benefits Security Administration at www.dol.gov/ebsa (1-866-444-3272) or the U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services at www.cms.hhs.gov (1-877-267-2323, ext. 61565).