According to the U.S. Department of Labor, 20.5 million people lost their jobs in April. As a result, many are now facing the prospect that they could lose their job-based health insurance plan. Between the loss of income and the potential financial impact of having to pay out-of-pocket for medical care, the result could be overwhelming for you and your family. Having access to health care is therefore critical during this unprecedented time. If you’re out of work due to the pandemic, here are a few ways you may be able to get health insurance.
- Consolidated Omnibus Budget Reconciliation Act (COBRA)
You may be able to continue your current health insurance under the Consolidated Omnibus Budget Reconciliation Act (COBRA). This is not always an affordable option since typically you would be required to pay the entire premium for coverage up to 102% of the cost of the plan. After receiving notice from your plan’s administrator, normally there is a 60-day window in which you may elect COBRA coverage. Then you would have 45 additional days to make the first payment. As a response to the COVID-19 pandemic, the Department of Labor (DOL) and the Internal Revenue Service (IRS) have extended certain COBRA deadlines during the “outbreak period” from March 1, 2020 until 60 days after the announced end of the national emergency period.
- Coverage as a Dependent
You may be eligible for employer-based coverage through a family member’s plan. You may have previously been covered as a dependent on a spouse or parent’s plan, or you may be able to switch from your own coverage to coverage as a dependent. Also note that if you’re younger than 26 years old, the Affordable Care Act (ACA) provides that you could be covered under a parent’s insurance policy.
You may be eligible for Medicaid if your income has fallen below certain state limits. For states that have expanded coverage under the ACA, you can generally qualify if your household income is below 138% of the federal poverty level. Note that while your income here would include any state unemployment benefits, the $600 per week federal supplemental unemployment benefit would not be included in this calculation. Eligibility for Medicaid varies in states that are not under the ACA, and is generally limited to incomes that are 50% below poverty.
- Children’s Health Insurance Program (CHIP)
If you have children, insurance coverage through the Children’s Health Insurance Program (CHIP) could be an option. This program provides low-cost health coverage to children in families earning too much money to qualify for Medicaid benefits. All states offer comprehensive CHIP coverage (i.e., routine check-ups, immunizations, doctor visits, emergency services, etc.), and work closely with their state Medicaid programs. In some states, CHIP covers pregnant women. There is no limited enrollment period for either Medicaid or CHIP — you can apply any time of the year and coverage could begin immediately if you qualify.
- Affordable Care Act (ACA) Marketplaces
If you don’t qualify for government programs such as Medicaid or Medicare, you may be able to find a healthcare plan through an Affordable Care Act marketplace in your state. Subsidies for marketplace coverage are available to a family income between 100% and 400% of the federal poverty level ($12,490 to $49,960 for individuals, $16,910 to $67,640 for a family of two and $25,750 to $103,000 for a family of four). Unlike for Medicaid, income here includes any state and federal unemployment benefits received, including the $600 per week federal supplement. Although most open enrollment periods have ended, special enrollment periods may be available in response to the pandemic. To find out about special enrollment, look up the ACA marketplace or health insurance exchange in your state (e.g., in California you could go to https://www.coveredca.com).
- Short-Term Plans
Short-term health insurance plans may be available to you if you’re currently out of work. They’re usually offered for one year terms which can sometimes be renewed. Although these plans generally have lower premiums, ACA subsidies cannot be used toward them. Another drawback is that they often provide fewer benefits and may deny coverage for pre-existing conditions.
- Community Health Centers
If you can’t afford a health plan and are unable to qualify for government programs, low-cost health care at nearby community health centers may be available. The cost of care depends on your income. Located in both urban and rural areas, community health centers provide a wide range of services, including prenatal care, baby shots, general primary care, and referrals to specialized care including mental health. Note that during this global pandemic, your local health center may not currently have COVID-19 testing capability. Call or go online in advance to confirm if a center has COVID-19 screening. You can go to https://findahealthcenter.hrsa.gov to find a nearby community health center.