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 cover premiums for senior citizens. In addition, some insurers are not offering life insurance to applicants who have underlying medical conditions that make them more susceptible to COVID-19.

These conditions include respiratory and heart conditions. Some insurers won’t accept applications from individuals who have tested positive for the virus within the last 30 days. This does not mean it’s impossible to get coverage if you are a senior citizen. Talk to your broker about your options. There are still carriers who offer whole life policies to those over the age of 70. age 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.

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