If you find yourself unemployed, unexpectantly laid-off or living off a low-income one of your major concerns will most likely be health insurance.
The stress of knowing whether you or your family’s health coverage will be available during this time can be quite a burden.
However, it’s important to know that you do have options that you could be eligible for to ensure that you maintain or obtain your health insurance coverage in some form.
There are a few options currently available which we will outline below in detail:
1. COBRA (Consolidated Omnibus Budget Reconciliation Act)
What is COBRA and how do I qualify?
COBRA or the Consolidated Omnibus Budget Reconciliation Act is essentially a law that helps cover an individual that has recently lost their job.
Employees that are covered by COBRA will be eligible for extended coverage of their currently existing health insurance plan for a limited time after the termination of their employment.
In layman’s terms, if you are fired or lose your job, under COBRA, you would continue to be covered by the health insurance you had whilst working, for a limited time.
The Consolidated Omnibus Budget Reconciliation Act is a federal law that was enacted in 1985. It entails that all employers outside of the federal government who have 20 or more employees offer COBRA coverage to individuals that qualify.
Checking to see if you’re eligible for COBRA coverage is based on what are called “qualifying events”. Below are terms that allow for eligibility:
- You need to have been covered by your employer’s group health plan/insurance.
- You need to have been subjected to circumstances that cause you to no longer be covered by your employer’s group health plan. These circumstances could be your jo termination, retirement, or a reduction in working hours.
- You are the spouse, or ex-spouse of someone who was eligible for COBRA coverage.
If your situation is not as clear as the terms indicated above and you’re unsure of whether you’re eligible you should contact your company’s human resources department and inquire further.
How does COBRA cover me?
As previously mentioned above COBRA extends your health coverage after your employment has been terminated. Your COBRA rights should be included in your initial documentation of enrolment in your health insurance plan.
However, you should be informed by your employer and your health insurance provider. Once you have received notification of the termination of your employment you will have up to 60 days to decide as to whether you would like to continue your health coverage under COBRA.
This coverage will begin the day after your employment is terminated and will allow you to receive the same benefits as before. This is advantageous as it allows you to retain the doctors and providers that you were using previously.
Keep in mind that the premiums for your insurance would be higher than that of when you were employed if your employer was paying towards your monthly premiums as a benefit every month.
How long does COBRA coverage last?
Depending on your situation COBRA coverage can last anything from 18-36 months, or until you find another place of employment.
This is also dependent on your premiums being paid timeously. To ensure that you are fully informed as to what you’re eligible to under the coverage contact your health insurance provider.
2. Medicaid and CHIP (Children’s Health Insurance Program)
Medicaid is a state/federal funded program that serves to provide health coverage to millions of Americans country-wide.
Medicaid covers individuals that have low incomes, are disabled, elderly, pregnant women and children.
Medicaid programs are available in every state, with the reach of the program differing from state to state.
Medicaid has a wide variety of programs that you might be eligible for depending on the financial requirements of that program.
Your financial eligibility will determine which programs you’ll be viable to apply for. In order to check your eligibility for any Medicaid programs you can contact your local Medicaid office.
One of these programs made possible by Medicaid is CHIP (Children’s Health Insurance Program).
In every state across the country CHIP is available to families that have children, or are expecting and are low-income individuals. CHIP serves to offer low-cost health coverage to these families.
Often these are families that earn too much to be financially eligible for Medicaid but not enough to get private health care insurance.
How do I know if my child is eligible?
From state to state eligibility of getting into the Children’s Health Insurance Program differs. However, applications are easy, accepted throughout the year and can be done simultaneously with any Medicaid application.
Every state’s CHIP program works closely with the state’s Medicaid program thus allowing you to check you and your child’s eligibility easily. If you or your child qualifies for the CHIP program you will be eligible for the following benefits/cover:
- Doctor visits
- Routine Check ups
- Dental Care
- Vision Care
- Hospital Care (in/out-patient)
- Emergency services
Benefits of cover does vary state to state be sure to check with your state’s CHIP benefits.
Some benefits will be free however others might require co-payments depending on the state on the service.
How do I apply?
There are two ways you can apply for this program. Either you can:
- Call this number 1-800-318-2596
- You can apply through your local Health Insurance Marketplace. If you fill out an application and it’s found that anyone in your family is eligible for Medicaid or CHIP benefits your case will be referred to your state agency.
Similar to Medicaid, Medicare is a federally funded program that serves to give health insurance to individuals that are over 65 years of age, under 65 years of age but are receiving Social Security Disability insurance or are under 65 years of age with End-Stage Renal Disease.
Unlike Medicaid that provides for low-income individuals, income is not a determining factor when it comes to Medicare coverage.
Benefits of Medicare
If you have Medicare coverage you will eligible for the following benefits:
- Most doctors across the country will be accept Medicare coverage
- You will be eligible to see specialists without having to receive any authorisation.
- Medicare limits how much participating and non-participating providers can charge you.
Medicare is split into three parts:
Medicare Part A – which covers inpatient stays at the hospital, hospice care, care at a nursing facility and home health care.
Medicare Part B – This is a sort of Medical insurance that covers outpatient care at the hospital, doctor’s services, preventative care and medical supplies.
Medicare Part D – This part works with private health plans that are approved by Medicare. It serves to add coverage to any prescription drugs to:
- Medicare medical savings account plans
- Original Medicare
- Medicare Cost plans
- Medicare Private-Fee-For-Service plans
If you’re unsure of what coverage you currently have, call 1-800-MEDICARE
How do I apply for Medicare Coverage?
You can apply for Medicare online under social security benefits.*
4. The Health Insurance Marketplace
The Health Insurance Marketplace or Health Insurance Exchange is a virtual place where individuals without health insurance can look for information on different health insurance plans and purchase health insurance plans.
The Health Insurance Marketplace allows you to apply for insurance that fits your financial eligibility thus allowing you to find cost effective health insurance.
The Health Insurance Marketplace is federally run, but there are also state based Marketplaces that you can enroll in.
Why use the Health Insurance Marketplace?
Health Insurance Marketplaces are extremely beneficial when it comes to looking for insurance that is completely transparent and accountable against governmental guidelines.
So not only are you gaining access to health insurance that suits your pocket financially but also you’re fully informed of the ins and outs of the plan and the coverage it has to offer you.
The idea behind the Health Insurance Marketplace was that Americans had a one stop “shop” where individuals could be fully informed on what Health Insurance plan options were available to them without having to get multiple consultations from different providers.
With one application you could find out what you’re eligible for.
How do I apply?
If you go online* you can check your eligibility for enrolment in the marketplace. Here you can enter your zip-code to find whether you can enroll in the country wide marketplace or the state-based one.
5. Private Health Insurance Marketplace
Health Insurance Marketplace run by the federal government is a social security-based marketplace.
As mentioned above this market exchange gives people access to affordable health insurance plans, and even state-run programs if they’re eligible.
All these insurance plans are ACA compliant, meaning they run in accordance to the Affordable Care Act of 2010.
However, if you’re looking for a health insurance plan that runs in accordance with the ACA but also stretches further than that of a basic plan you might want to shop for your insurance on a private market exchange.
Here you will be able to find private health insurance that you can customise more to your needs both medically and financially.
Working with a private health insurance market exchange you can get free quotes on different plans available to you, easily compare any plans that are offered to you, get a more personalised approach to your situation like expert advice on what plan might be best for you, as well as advice on how to approach any claims or queries into insurance details.
With the above details on differing programs and avenues of attaining health insurance across the country, we hope this will provide useful in reducing any stress that has been incurred through the loss of your employment.
Access to health insurance is an essential part of maintaining a health body, and this can be made possible through the above programs. Whether it be for the young, elderly or low-income individuals.
Ranging from government funded programs and subsidies, to avenues of attaining health insurance that can help support your care. We hope this article serves to make attaining health insurance more accessible to you in this time.