Most working-age Americans get health insurance through their employer. Which means a loss of work during a coronavirus pandemic can mean losing your health insurance.
In recent economic crises, options for buying affordable health insurance have been limited. But the provisions of the Affordable Care Act, along with action taken recently by Congress and some states, mean more opportunities to get coverage. Here is a guide to the options, which differ depending on your circumstances.
I just lost coverage based on my work, but I would really like to keep it.
You can keep your insurance coverage for as long as 18 months under the federal law known as the Treasury Omnibus Budget Reconciliation Act (COBRA). But only if you want to pay the same amount of your premium (monthly fee) – both what you normally pay and what your employer contributed to your premium.
Although particular circumstances vary, COBRA coverage tends to be more expensive than coverage in the Obamacare markets. It can be a particularly desirable option for anyone in the middle of treatment for an acute or chronic condition because it will allow you to keep seeing the same doctors. Your employer may be willing to subsidize some of your monthly expenses for a period.
I just lost my job, and my income is close to zero.
In 36 states (plus the District of Columbia), you are more likely to qualify for the federal-state health insurance program called Medicaid. Because of Obamacare, most states now allow all residents to qualify for Medicaid if their family’s monthly income is below a certain limit – about $ 1,400 for a single person or $ 2,950 per month for a family of four.
For somewhat complicated reasons, the best way to apply for Medicaid if you are in this situation is to go directly to your state Medicaid agency, not the Healthcare.gov site.
Medicaid coverage is usually low or very low premium and has very low copayments when you go to the doctor or fill out a prescription. But it tends to cover fewer doctors than work-based coverage insurance does.
If you live in a state that has not expanded its Medicaid program, qualifying for coverage may be more difficult. You may need a parent or meet other qualifications. Your child may qualify for coverage even if you do not.
If your monthly income is low enough to qualify for Medicaid but you expect your annual income to be higher than the above income limits, you may also choose to purchase an Obamacare market plan, probably with substantial grants. See below.
I just lost my job and benefits, but my family still has some income.
If you have recently lost your employment-based coverage, you may be eligible for a special registration period to purchase the Affordable Care Act stock market insurance. Protection is subsidized on a sliding scale based on income, and there are several options in the plan in most markets.
To look at your options, Healthcare.gov is a good first stop. Some states list insurance options on their websites, but the federal site is pointing you in the right direction.
Depending on your state of residence, you may need to provide documentation that you have recently lost your job. You may also need to prove that your income is now lower than it was when you filed your last tax return, if it fell.
I’m currently buying Obamacare insurance, but I’m making less money than usual.
Supported coverage for Obamacare is calculated at the beginning of the year, based on estimated revenue for this year. And if you bought insurance and your income changes, you can go back to the market and adjust. You may need to provide proof of income changes, such as a termination letter or a recent check.
At the end of the year, your grants will remain once you file your taxes. If you incorrectly calculate and receive too much of grants, you will have to repay the difference then.
I haven’t bought health insurance this year, but I would like some now in case I get the coronavirus.
Normally, you can only sign up for insurance once a year unless something important in your life changes, such as a job loss, a divorce or a move to a new insurance market. But because of the coronavirus pandemic, some employers and states are loosening those rules. So far, 11 states and the District of Columbia are allowing uninsured residents to sign up for Obamacare plans now, regardless of why they are uninsured. The states are California, Colorado, Connecticut, Maryland, Massachusetts, Minnesota, Nevada, New York, Rhode Island, Vermont and Washington, and you can visit their insurance market websites.
Some employers are doing the same, so it may be worth checking with your company’s human resources department if you are still working and qualified for job-based protection.
I bought a long-term health plan this year, but now I would like a more complete one.
In short, long-term health plans are less likely to cover coronavirus testing and treatment than more comprehensive plans offered through Medicaid, Obamacare marketplaces, or most workplaces. If you have bought a plan like this and want to change to a wider one, your options are similar to those for people with no insurance. If you are in a state with a special enrollment period, you can sign up for Obamacare insurance now. If your employer offers a special enrollment period, you may also be able to enroll in this type of coverage.
But, if you are in a state that has not changed its normal policy, you will be eligible to enroll in new coverage only if you have a qualifying life event such as a divorce or if your income is low enough that you qualify for Medicaid.