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Groups Goal Guide: Insurance and Health Care

At Groups, our comprehensive care model supports the whole you. This includes challenges in life that can sometimes get in the way of meeting short- and long-term goals, like access to health care.

Whether you’re considering your insurance options or you’re paying out of pocket for health care, we’re here to help. In this Groups Goal Guide, you’ll find resources for enrolling in Medicaid, and for accessing free or low-cost care and services. Check out our open enrollment guide if you have questions about the open enrollment period that occurs every year between October and January. 

Do you qualify for Medicaid?

Medicaid is a health insurance coverage program funded by states and the federal government. As of June 2023, 85.6 million people were covered by Medicaid. Every state has different qualification criteria, but it’s most commonly based on income level, pregnancy, disabilities, and age. 

Medicaid coverage may include many ways to save on important care, services, and daily needs:

  • Adult and child health, dental, and vision benefits
  • Equipment and education for specific health conditions
  • Money for reaching recovery, health, and mental health milestones
  • 24/7 telehealth and nurse advice line
  • Over-the-counter drug coverage
  • Support for new parents (including breast/chest pumps and doula services)
  • Help with balanced nutrition and regular exercise
  • Help with transit needs (e.g., transit benefits, mileage reimbursement for getting to appointment, car seats, booster seats)
  • Help with continuing education, employment, and legal needs (getting a license, state ID, re-entry and expungement support)
  • Free personal care kits

Here’s how to apply for Medicaid in the states Groups serves:

Arizona

California

Florida

  • Apply online, print an application, or request a paper application be mailed to you.
  • Apply by phone by calling (850) 300-4323.

Indiana

Kentucky

Maine

Nevada

  • Apply online.
  • Print and fill out a paper application and drop it off at or mail it to your local Welfare office. To find the location of your local Welfare office:
  • Apply in person at your local Welfare office, at a Federally Qualified Hospital, or with an application assister.
  • Apply by phone by calling (800) 992-0900 or by calling your local DWSS Call Center at:
    • Northern Offices: (775) 684-7200 
    • Southern Offices: (702) 486-1646 

New Hampshire

  • Apply online or request a paper application be mailed to you.
    • If completing online and you have previously applied, you will need a PIN. Call 1 (800) 852-3345 to get your PIN.
  • Apply in person at your local DHHS office.
  • Apply by phone by calling 1 (800) 852-3345.

South Carolina

Tennessee

Virginia

West Virginia

  • Apply online.
  • Print and fill out a paper application and either mail or fax it to your county DHHR office. 
  • Apply in person at your county DHHR office.
  • Apply by phone by calling (877) 716-1212.
  • If you are unable to go to the local office because of a disability, you may request a staff person to visit your home and take the application. To request a home visit, call your county DHHR office or Client Services toll-free at (800) 642-8589.

If you don’t qualify for Medicaid:

  • A Health Exchange plan may be an option.
  • In Indiana, Groups offers a grant program for uninsured members, the SOR grant, through the State of Indiana. To qualify, your income needs to be greater than the Medicaid limit and you must not have a third-party payer (Medicaid, Medicare, commercial insurance, out-of-network insurance, or another grant source).
  • In Maine, Groups offers a grant program for uninsured members, the Uninsured Opioid Health Home Program. To qualify, your income needs to be greater than the Medicaid limit and you must not have a third–party payer (Medicaid, Medicare, commercial insurance, out-of-network insurance, or another grant source).

Groups accepts many states’ Medicaid plans, as well as commercial insurance. Speak with the Groups Entitlement team for assistance with enrolling in Medicaid or other insurance plans.

Do you qualify for Medicare?

Medicare is a federal health insurance program for:

  • People who are 65 or older
  • Younger people with certain disabilities
  • People of all ages with end-stage renal disease

If you’re not sure if you qualify, complete an eligibility assessment through the Social Security Administration.

You can apply for Medicare by visiting online or by calling 1 (800) 772-1213.

Once you enroll in Medicare, you’ll need to choose between original Medicare or Medicare Advantage. Learn more about your options.

Groups accepts original Medicare and some Medicare Advantage plans. Speak with the Groups Entitlement team for assistance with enrolling in Medicare or other insurance plans.

Free or low-cost care in your area

You can find free or low-cost health care at:

Free screening

Many local health departments offer free cancer screening. There are also several organizations and clinics that provide cancer screening, sexually transmitted infection (STI) testing, and diagnostic services, including:

Our Entitlement team can also help you find a local health department, organization, or clinic that can provide you with free cancer screening, STI testing, and diagnostic services.

Free or low-cost vaccination

Many adults and children are eligible for free or low-cost vaccination. These resources can help you see what your options are:

Prescription medication savings

The following companies, programs, and actions can help with prescription costs:

Financial assistance for other bills

Reducing the costs of other bills can help make health care and insurance more affordable:

Want personalized support for getting the health care you need? Our Entitlement team is here for you. So far, Groups has helped over 4,500 members with health care and other life needs.

New to Groups? We’re a leading provider of medication for opioid use disorder (MOUD). We combine treatment, weekly group therapy, and support for accessing the things people need to thrive (like health care).

Reach out anytime, day or night, to see if Groups is right for you.

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