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Fall 2020  Volume 13, Number 3        
 

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Your Options if You Lose Your Employer-Sponsored Health Care Coverage

Estimates are that more than 26 million people could become uninsured due to the workplace shutdowns.

The Economic Policy Institute estimates that because of the COVID-19 virus and workplace shutdowns, 16.2 million American workers have lost their employer-sponsored health care coverage since mid-March. The Kaiser Family Foundation estimates that 26.8 million people in the U.S. (including employees and their dependents) could become uninsured after losing employer-based insurance if they don't enroll in other coverage.

Experts at the Urban Institute think tank encourage individuals who lost their coverage not to wait to get insurance. The research and decision-making process can take time and some coverage options involve deadlines. And with the pandemic still active, some people are at a significant risk of incurring serious health problems.

If you have joined the ranks of those who lost their employer-sponsored health care coverage, be assured that you have options to protect your and your family's health. Here are some valid alternatives to getting health care coverage through your employer:

Individual Health Care Plans

Although usually you can purchase health insurance during the annual enrollment period, "involuntary loss of coverage" is a qualifying event that triggers a special enrollment period. If you lose your health care plan because you lost your job, you can enroll in a new plan if you prove that the coverage you are losing is:

  • Considered minimum essential coverage (individual short-term plans don't count since they are not considered minimum essential coverage).
  • Related to loss of pregnancy-related Medicaid coverage, CHIP unborn child and Medically Needy Medicaid. These are not considered minimum essential coverage, but their termination does trigger a special enrollment period.
  • A grandmothered or grandfathered plan, even if it is not ACA-compliant.

Affordable Care Act (ACA) Health Insurance Marketplace You may qualify for a Special Enrollment Period (SEP) and be able to purchase a plan on your state's marketplace. You will need to provide documentation that you have had a qualifying event within the last 60 days and are eligible for coverage. This proof could include:

  • An employer letter indicating termination of employment or reduction in hours
  • Marriage certificates
  • Birth certificates

If you didn't lose your job, but you had a reduction in income that makes you eligible for financial assistance in the exchange, you qualify for a special enrollment period. If your income in 2020 falls between 100 percent and 400 percent of the federal poverty level, you can qualify for insurance premium subsidies. Again, you must have already had minimum essential coverage before your income level changed.

Twelve states that run their own marketplaces, as well as the District of Columbia, have reopened their open enrollment. However, most of those deadlines have passed, with the exception of D.C., whose deadline does not close until Sept.15.

COBRA

The Consolidated Omnibus Budget Reconciliation Act, or COBRA, allows you to continue your employer's health care coverage after you’ve lost your job — provided you worked at a company that had 20 or more employees. This is a short-term solution and you may be required to pay up to 102 percent of the entire premium since you will be paying your and your former employer's costs. This option is best suited to those who are currently undergoing treatment for a chronic condition or who are pregnant and don’t want to change health care providers.

Employer-Based Coverage

If your spouse has coverage through their employer, you might be able to get coverage through that plan. Or, if you’re younger than 26, the ACA allows you to be covered under your parents' insurance plan.

Short-Term Health Plans

Short-term plans are just what their name implies — they provide coverage for a limited time only. They also aren't considered minimum essential coverage and aren't ACA-compliant. They are, however, very inexpensive. Monthly premiums can be as low as $25. But they offer limited benefits. Just be sure you understand what is and is not covered because this is not the same as traditional coverage. In addition, anyone with a pre-existing condition can be denied coverage.

Medicaid Coverage

You may be able to qualify for Medicaid — even if you don't think you qualify. Medicaid offers free or low-cost care and comprehensive benefits to those who live in states that allow coverage for households whose monthly income is 138 percent of the federal poverty level.

Please give us a call if you have questions.

 

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In this issue:

This Just In...

Your Options if You Lose Your Employer-Sponsored Health Care Coverage

The Hidden Costs of $0 Premium Medicare Plans

What You Need to Know About Getting Health Insurance for Yourself — and an Employee

How Your Credit Score Reveals Your Suitability for Life Insurance

 


The information presented and conclusions within are based upon our best judgment and analysis. It is not guaranteed information and does not necessarily reflect all available data. Web addresses are current at time of publication but subject to change. SmartsPro Marketing and The Insurance 411 do not engage in the solicitation, sale or management of securities or investments, nor does it make any recommendations on securities or investments. This material may not be quoted or reproduced in any form without publisher’s permission. All rights reserved. ©2020 The Insurance 411. www.theinsurance411.com Tel. 877-762-7877.