American’s as a whole already have staggeringly high rates of individuals who lack health insurance. There are many reasons for this: plans are often too expensive, while eligibility thresholds for government benefits are too low. Furthermore, many individuals cannot afford traditional, privately bought plans. Couple this with the mass job loss resulting from the Covid-19 pandemic and there is a recipe set for disaster.
The above in combination leaves individuals in a bind: we are in a time when we need health insurance more than every but are in a uniquely challenging spot to receive or afford it.
Below, we outline the most accessible ways for individuals to regain coverage while they are unemployed and qualifications of special coverage groups such as Medicare, Medicaid, and CHIP.
The Options That Work for Most
Across the board, Special Enrollment plans and COBRA coverage is the preferred option for most individuals experiencing job loss.
Many individuals don’t realize that losing a job triggers a Special Enrollment Period for marketplace coverage. As the name suggests, this is an enrollment window outside of when the health insurance marketplace is ordinarily open. The period lasts for 60 days after losing your job, giving you time to find an alternative and affordable healthcare plan.
Job loss is not the only trigger for such a period, however.
- Marriage that can result in a change of coverage
- Death of another member on the same marketplace plan
- Adopted a child
- Lost health coverage after a divorce or legal separation
- Lost health coverage due to job loss, being furloughed, or a reduction of working hours
For more information on how to qualify, see our article on it, here.
The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federally mandated safety net for employees who depend on their employers for health insurance coverage. Through this program, you can elect to maintain the same plan coverage you had through your employer for up to 18 months after your employment ended.
However, for individuals experiencing unemployment, COBRA comes with some marked downsides in pricing.
Because employee provided plans are subsidized (your employee pays for part of it), enrolling in COBRA can be more costly than many can afford. The reason for such a significant jump in price is that employers typically subsidize 75% of the total cost of your plan. Additionally, they pay for a 2% administrative fee. Through COBRA, all these added expenses become your responsibility.
However, there is an upside: you may elect to enroll in COBRA coverage and still have the option to cancel later if you find the cost is not feasible.
The Options that Work for Some
While the above two options work for many, if you qualify for other health insurance options, there may be more cost-effective ways of continuing your medical benefits.
Short Term Health Insurance
Short-term health insurance plans are designed to bridge gaps in coverage for individuals who are unemployed, between jobs, or those suffering from other circumstances that caused a lapse in coverage. These plans often offer less extensive coverage for individuals who can’t, or don’t want, to pay for major medical coverage.
While short-term may seem appealing for the chance at low premiums at first, this type of coverage often lack-luster for most individuals.
The expense of short term plans varies greatly depending on your provider and the type of coverage you select. While some plans can have low monthly premiums, it is common for short-term plans to have higher deductibles or a significantly reduced scope of coverage.
Unfortunately, individuals with pre-existing conditions may not be covered at all. This creates a variety of challenges as nearly half of all Americans have some form of a pre-existing condition. Furthermore, since short-term plans require you to re-apply at the end of each term— developing a pre-existing condition now loses your coverage later.
Medicaid, Medicare, and CHIP
These three government programs are all federally subsidized forms of health insurance that help individuals or families who meet specific enrollment requirements. These programs allow disabled and low-income individuals to find affordable health insurance and potentially provide long-term coverage.
Medicaid is a needs-based program supposed by social security tax payments. For individuals below a certain income threshold and asset cap, they can apply for this type of insurance policy. To find out if you qualify for Medicaid coverage, look to medicaid.gov for more.
Medicare, while similar, is based on entitlement and need. As such, individuals over the age of 65 of those with a qualifying disability are eligible to apply for this kind of coverage. For more information on Medicare eligibility, see the eligibility requirements on hhs.gov.
CHIP, also known as the Children’s Health Insurance Program, is for families who earn too much for Medicaid but too little to afford health insurance for their children through other means. CHIP has a strong connection to the Medicaid program, thus, more information about the program is located at medicaid.gov.
Casa Grande Insurance Agents
With the constant changes in the landscape as the coronavirus pandemic, ensuring you and your family have health insurance coverage is critical.
At the Gebhardt Insurance Group, we offer a variety of coverage from a host of major insurance carriers with an experienced staff that can help you determine the coverage you need. We can help everyone from individuals looking for a basic health policy to families, persons with pre-existing conditions, and even those looking to purchase life insurance.
If you have any questions, give us a call at 520-836-3244 to get a quote and make an appointment to take the final steps in insuring yourself and your family.