What to do if you lose your health insurance during COVID-19

Things in our personal lives are changing at the speed of light right now. Each day there is new information. We are constantly learning how to navigate the changing landscape in which we find ourselves. For many, these changes can include a reduction or complete loss of income and benefits as job hours are reduced or eliminated.

One of the biggest benefits that you may lose is health insurance. Because nearly half of workers in the U.S. get their health insurance coverage through their employer, this can leave you wondering what to do. If your hours are cut or you lose your job entirely, it’s important to maintain health insurance. There are several ways to do so.

Option 1: COBRA

If you have recently lost health insurance due to an employment change, one option is to apply for insurance through COBRA. Most employers in the U.S. with 20 or more employees offer COBRA to their employees and their families. The program allows you to extend your employer-sponsored health care for up to 18 months. And you have 60 days after losing coverage to apply for benefits under COBRA.

The one major drawback to COBRA is that it is usually expensive. Normally, with employer provided insurance coverage, the employer pays for a portion (on average around 80%) of the premium. On COBRA, however, you have to pay the entire premium yourself. You will also be responsible for the administrative fees that your employer paid on your behalf. Your employer should notify you of your eligibility for COBRA within 14 days of your job status changing. Then you can elect to have COBRA coverage before your 60-day window expires.

Option 2: Insurance under the Affordable Care Act (ACA)

If maintaining your employer sponsored care through COBRA is cost-prohibitive, you should apply for health insurance on the health insurance exchange. Losing your health benefits is a qualifying event. It will allow you to apply for insurance on the exchange, even if the open enrollment period for the year is closed. Again, with this program, you have 60 days after losing your job to apply for benefits.

Many individuals and families with modified adjusted gross incomes less than 400% of the federal poverty level qualify for a federal subsidy to offset the cost of ACA insurance plans. This would mean $49,960 for a single person and $103,000 for a family of 4 in the continental US. California has added its own subsidies to reduce costs.

To apply for insurance under the ACA, make sure that you are going through the legitimate site. There are several that look similar, but sell non-compliant policies. Start here and it may then connect you to your state’s health insurance exchange.

When you apply for health insurance through the exchange, you’ll need to estimate your income for the calendar year. It can be difficult to do this when unemployed. Take into consideration all anticipated sources of income for yourself and your family members, including unemployment insurance, wages, and alimony.

Be sure to find a policy with benefits that are right for both your health and financial situation. Consider benefits, out-of-pocket costs, and your monthly deductible. Hopefully you can find a coverage option in your price range.

Option 3: Medicaid and the Children’s Health Insurance Program (CHIP)

If you expect your household income to be less than 138% of the federal poverty level, you may qualify for Medicaid. Medicaid offers free or low-cost health care. This would be $17,236 for a single person or $38,625 for a family of four. According to the federal government, low-income families, qualified pregnant women and children, and individuals receiving Supplemental Security Income may qualify.

Some states have expanded Medicaid to cover additional groups like:

  • individuals receiving home and community-based services
  • children in foster care
  • adults with income below a certain threshold

Free or low-cost health care coverage for pregnant women and children in households with slightly higher incomes may be available through your state’s Children’s Health Insurance Program (CHIP).

How to Get Started

The variety of health insurance options available can be confusing. However, the good news is that you should be able to complete a single application and find out what support is available to you through the health insurance exchange.

If you’re struggling with the application process or understanding your options, you can get an appointment with a Navigator or Certified Application Counselor affiliated with a local non-profit.

In these uncertain times, it’s so important to take care of your own health and the health of your family. Even with job loss and situation changes, there are options to get and maintain health insurance coverage. Take time to research your options and understand the conditions you need to meet. Then find the best-fit coverage for you and your family. You can rest easier knowing that you are covered!

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