One way or another any cut in income is going to influence your approach to health insurance for you and your loved ones. This article will discuss the ways to get health coverage if someone has lost job and health insurance due to Coronavirus.

There are many different scenarios and we will describe the most likely ones.  Our first and most important advice is that you should discuss your circumstances with your employer, insurance company or your chosen Health Exchange.  Some of your options are time-limited. Our second piece of advice is to start your investigation now!

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Most working-age Americans (and their families) are insured through their employers.  When you lose your job, you will almost certainly lose your health insurance.  So, let look at these possibilities to get Health insurance in the wake of loss of job

Option 1: COBRA

You may want to keep the same insurance plan.  You are perfectly entitled to do so. BUT you will have to pay the full premium i.e. your share and the contribution your employer was making +2% administration fee.  This is normally an expensive option but MAY be good value if you are certain of regaining your income quickly OR if you or a dependent is in the course of medical treatment and you (they) prefer to stay with the same network of providers.  To take this option (COBRA) you must sign up within 60 days of losing your job.  The maximum extension is 18 months but you may switch plans during Open Enrolment or if you have another SEP. See our article ‘Sign up for COBRA’.

Option 2:  Get covered through a family member

If another member of the family, normally a spouse, has or is entitled to employer-sponsored, group health insurance you should consider the option of joining their plan. IF you are less than 26 years of age you can join your parent’s plan.  Both these options have a 30 day enrollment window.

Option 3: ACA Special Enrollment Period

Losing one’s job (or experiencing a severe change in financial circumstances, see section d below) triggers a Special Enrollment Period (SEP). This is a 60-day period. During this window you can investigate alternative ACA compliant plans.

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Premiums are subject to tax relief and income-related subsidies, which in some cases, can result in very low or zero net costs.  Your Health Insurance Exchange can help you find the plan that best meets your new circumstances and which qualify for benefits.

Option 4: Medicaid

If you lose your job without finding another or, move to another on significantly lower pay, the same window opens (SEP) as above.  You may request to modify your (independent) market plan OR (depending on your state regulations) you may qualify for the federal/state health insurance program AKA Medicaid.  In most states you will qualify if your monthly household income is below $2950 ($ 1400 for an individual).  If you believe you and your family qualify you should contact (BY PHONE) your state Medicaid Agency directly.  Medicaid provides cover that meets the ACA standards but services may be more limited than work-based or open market plans.  Although Medicare may provide coverage at little or no cost you MUST ENROL to take advantage. You may find that tax relief and subsidies make market place plans that offer more flexibility and better value. EXPLORE BOTH OPTIONS.

Option 5: Short-term health insurance plans

If you have a clear idea of your plans for the near future, for instance, new job with employer insurance, or moving abroad you could consider a short-term insurance plan. These plans are typically less expensive (monthly premiums) than ACA compliant plans, generally cover fewer medical services and do not attract subsidies or premium tax relief. They can be renewed for up to 36 months.

In all cases you will need supporting documentation to confirm: –

  1. Date of termination
  2. Date of insurance cessation
  3. Evidence of any applicable “qualifying event” e.g. marriage, low income.

OUR FINAL ADVICE is the same as the first. Discuss your circumstances with your employer, insurance company or your chosen Health Exchange.  Some of your options are time-limited.  Do it now!

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