Do You Need Comprehensive Health Coverage During the Pandemic? You Have Options
Do you need comprehensive health coverage during the pandemic? You have options.
Since the COVID-19 pandemic began, a record-breaking number of people lost their jobs and their health insurance plans. Others want to sign up for health insurance, but aren’t sure if it’s worth the expense. There are several options, as well as ways you might qualify for help with insurance coverage costs, so you don’t need to remain uninsured.
TOP CONSIDERATIONS
Health insurance covers expenses that are important to staying healthy and treating illness and injuries. It also helps protect you against expensive medical costs. There are many different types of health insurance plans available to you at a variety of different prices. You will want to see if you are eligible for assistance and shop around to see which plan is best for you. Be sure to compare coverage along with costs.
THINGS YOU SHOULD KNOW
When you have health coverage, you usually pay a monthly premium and, in return, your health plan pays part of the bill when you need health care. Health insurance usually covers doctors' visits, prescription drugs, medical and surgical services. There are several routes you can take to obtain health coverage.
Special Enrollment in Your Spouse’s Plan. If you lost coverage recently and are married, consider requesting enrollment in your spouse’s group health plan. Losing coverage qualifies you (and your family) for an opportunity to enroll in many employer plans for which you are otherwise eligible, even outside of the plan's annual open enrollment period. To qualify, you must request enrollment, typically within 30 days of losing eligibility for other coverage. As a result of the COVID-19 outbreak, this 30-day deadline has been extended and details about the extension can be found here. You’ll have to pay any additional premium that applies under the plan for adding people to coverage.
Check your eligibility for Medicaid. If you’ve lost your job or had a reduction in hours, the sudden change in income might make you eligible for Medicaid. Medicaid eligibility is based on monthly income, so you may qualify even if you earned too much to qualify earlier in the year. Children with unemployed parents will likely be eligible for Medicaid or the Children’s Health Insurance Program (CHIP). Visit https://www.medicaid.gov/medicaid/eligibility/index.html to find out how to determine your eligibility.
Marketplace. Many people qualify for help in paying premiums for Marketplace plans. You can enroll in a Marketplace plan during the year when you qualify for a special enrollment period. In every state, if you are out of a job for any reason and lose your health insurance, you can buy a Marketplace plan. Several other life events, like a permanent move or having a baby, can also qualify you for new enrollment in a Marketplace plan. And several states have opened enrollment in these private plans without qualifying events, so almost anyone can enroll. During the application process, you’ll find out if you qualify for income-based savings on your monthly premiums and out-of-pocket health care costs.
Your family may be eligible for coverage as well. You usually have 60 days to enroll in the Marketplace from the time your employer sponsored coverage ends. You can apply for a Marketplace plan through https://www.healthcare.gov. Note that some states have their own health insurance Marketplaces, but healthcare.gov can direct you to the right place. When you apply, the Marketplace will also check your eligibility for Medicaid and CHIP.
COBRA. If you lost coverage through a job, you may be eligible for COBRA Continuation Coverage. Under COBRA, a federal law, you can pay to stay on your employer’s health insurance plan out of your own pocket after you lose your job for about 18 months after your employment ends. The deadline for deciding to enroll in COBRA coverage has been extended due to the COVID-19 outbreak.
You are responsible for payment of the full premium, and an administrative fee. This means you will pay about 102% of the full premium cost. COBRA is typically more expensive than Marketplace coverage and enrolling in it can change your eligibility for Marketplace help. So, you should check with the Marketplace before making any decisions.
Your dependents may be eligible for COBRA coverage too, whether or not you sign up yourself.
TOP THINGS TO REMEMBER
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If you’ve had a drop in income and you need health insurance, you may qualify for help paying your premium.
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Medicaid and CHIP enrollment are always open for those who qualify. You can enroll in Marketplace coverage right away if you lose other coverage, have another qualifying life event, or, in some states, just because you need coverage.
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COBRA allows you to remain on your employer's health insurance, but you will be responsible for the full cost and plus an administrative fee.
About the National Association of Insurance Commissioners
As part of our state-based system of insurance regulation in the United States, the National Association of Insurance Commissioners (NAIC) provides expertise, data, and analysis for insurance commissioners to effectively regulate the industry and protect consumers. The U.S. standard-setting organization is governed by the chief insurance regulators from the 50 states, the District of Columbia and five U.S. territories. Through the NAIC, state insurance regulators establish standards and best practices, conduct peer reviews, and coordinate regulatory oversight. NAIC staff supports these efforts and represents the collective views of state regulators domestically and internationally.