May 12, 2020
Do You Need Comprehensive Health Coverage During the Pandemic? You Have Options
DoÌýyou need comprehensive health coverageÌýduring the pandemic? You have options.Ìý
Since the COVID-19 pandemic began, a record-breaking number of peopleÌýlostÌýtheir jobsÌýand theirÌýhealth insurance plans.ÌýOthersÌýwant toÌýsign up for healthÌýinsurance, butÌýaren’t sureÌýif it’s worth the expense. ThereÌýareÌýseveralÌýoptions, as well asÌýways you might qualify for helpÌýwithÌýinsuranceÌýcoverageÌýcosts, soÌýyou don’t need to remain uninsured.ÌýÌý
TOP CONSIDERATIONSÌý
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 manyÌýdifferentÌýtypes ofÌýhealth insuranceÌýplansÌýavailable to you at a variety of different prices.ÌýYou will want toÌýsee if you are eligible for assistance and shop around to see which plan isÌýbest for you. Be sure to compare coverage along with costs.Ìý
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THINGS YOU SHOULD KNOWÌýÌý
When you have health coverage, youÌýusuallyÌýpay aÌýmonthlyÌýpremium and, in return, your health plan pays part of the bill when you needÌýhealth care. Health insurance usually covers doctors' visits, prescription drugs, medicalÌýand surgical services.ÌýÌýThere are several routes you can take to obtain healthÌýcoverage.ÌýÌý
Special Enrollment in Your Spouse’s Plan.ÌýIf youÌýlost coverage recentlyÌýandÌýare married, consider requesting enrollment in your spouse’s group health plan.ÌýLosing coverageÌýqualifiesÌýyou (and your family)ÌýforÌýan opportunity to enroll inÌýmany employer plansÌýfor which you are otherwise eligible, evenÌýoutside of the plan'sÌýannualÌýopen 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,ÌýthisÌý30-dayÌýdeadlineÌýhasÌýbeen extended and details about the extension can be foundÌý.ÌýYou’ll have to pay any additional premiumÌýthat applies under the plan for adding people to coverage.Ìý
Check your eligibility for Medicaid.ÌýIf you’ve lost your jobÌýor had a reduction in hours, the sudden change in income might make you eligible for Medicaid.ÌýMedicaid eligibility is based on monthly income,Ìýso you may qualifyÌýeven if you earned too muchÌýto qualifyÌýearlier in the year.ÌýChildren with unemployed parents will likely be eligible for Medicaid or the Children’s Health Insurance Program (CHIP). VisitÌýÌýtoÌýfind out how toÌýdetermine your eligibility.ÌýÌý
Marketplace.ÌýMany people qualify forÌýhelp in paying premiums for Marketplace plans.Ìý You can enroll in a Marketplace planÌýduring the year whenÌýyouÌýqualify for a special enrollment period.ÌýÌýIn every state,ÌýifÌýyou are out ofÌýaÌýjob for any reason and lose your health insurance, you can buy aÌýMarketplaceÌýplan.ÌýSeveral other life events, likeÌýa permanent move or having a baby, can also qualify you for new enrollment in aÌýMarketplace plan.ÌýÌýAndÌýseveral states have opened enrollment in these private plans without qualifying events, soÌýalmost anyone can enroll.ÌýÌýDuring the application process, you’ll find out if you qualify for income-basedÌýÌýandÌý.ÌýÌý
Your family may be eligible for coverage as well. YouÌýusuallyÌýhave 60 days to enroll in the Marketplace from the time your employer sponsored coverage ends. You can apply for a Marketplace plan throughÌý.ÌýNote that some states have their own health insurance Marketplaces, but healthcare.gov can direct you to the right place.ÌýWhen you apply, the Marketplace will also check your eligibility for Medicaid and CHIP.Ìý
COBRA.ÌýIf you lost coverage through a job,ÌýyouÌýmay be eligible for COBRA Continuation Coverage. UnderÌý,Ìýa federal law, you can pay to stay on your employer’s health insurance plan out of your own pocket after you lose yourÌýjobÌýforÌýabout 18 months after your employment ends.Ìý The deadline for deciding to enroll in COBRA coverage hasÌýbeen extended due to the COVID-19 outbreak.ÌýÌýÌýÌý
You are responsible for payment of the full premium,ÌýandÌýanÌýadministrative fee. This means you will pay about 102% of the full premium cost. COBRA isÌýtypicallyÌýmore expensive than Marketplace coverageÌýand enrolling in it canÌýchange your eligibility for Marketplace help.ÌýSo,Ìýyou shouldÌýcheck with theÌýMarketplace before making any decisions.ÌýÌý
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Your dependents may be eligible for COBRA coverage too,Ìýwhether or notÌýyou sign up yourself.ÌýÌý
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TOP THINGS TO REMEMBERÌýÌý
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If you’ve had a dropÌýinÌýincomeÌýand you need health insurance, you may qualify for help paying your premium.Ìý
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Medicaid and CHIPÌýenrollmentÌýare always open for those who qualify.ÌýYouÌýcan enroll in Marketplace coverageÌýright away if youÌýloseÌýother coverage, have another qualifyingÌýlife event, or, in some states, just because you need coverage.ÌýÌý
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COBRA allows you to remain on yourÌýemployer'sÌýhealth insurance, but you will be responsible for the full cost andÌýplusÌýan administrative fee.Ìý
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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 (²»Á¼Ñо¿Ëù¹Ù·½) 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 ²»Á¼Ñо¿Ëù¹Ù·½, state insurance regulators establish standards and best practices, conduct peer reviews, and coordinate regulatory oversight. ²»Á¼Ñо¿Ëù¹Ù·½ staff supports these efforts and represents the collective views of state regulators domestically and internationally.