Losing a job can be a stressful and challenging experience, and one of the many concerns that may arise is how to maintain access to essential healthcare services. Health insurance is a critical component of overall well-being, providing financial protection and access to medical care when needed. Fortunately, there are several avenues available for individuals who are unemployed to secure health insurance coverage. In this article, we will explore some options and provide guidance on how to navigate the process.
Explore COBRA Coverage
The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal law that permits eligible workers to keep their employer-sponsored health insurance coverage for a set length of time when they lose their jobs. While COBRA coverage may be more expensive than what you paid when employed, it frequently provides access to the same benefits and network of healthcare providers. Within 60 days after losing your employment, contact your former employer’s human resources department and inquire about COBRA coverage. To be eligible for COBRA coverage, you must have been covered by your employer’s health plan while employed, and your employer must have at least 20 employees. COBRA coverage is also offered for eligible dependents (spouse and children) in the event of job loss, divorce, or other qualifying situations.
COBRA coverage normally lasts from 18 to 36 months, depending on the conditions. The term can vary depending on criteria such as the reason for job loss and any extensions granted due to disability. While COBRA allows you to keep the same health insurance coverage you had while employed, it can be more expensive. Under COBRA, you are responsible for paying the entire premium, including the portion that your employer previously paid. This can lead to much higher monthly rates. However, it may still be less expensive than other options, particularly if you want to keep your current healthcare providers or have certain medical needs.
After you lose your employment, your employer must present you with a COBRA election notice within 44 days. This letter includes information regarding your eligibility, coverage costs, and enrollment deadlines. You normally have 60 days from the date of the notice to determine whether to elect COBRA coverage. If you decide to join, you must pay the initial payment within 45 days.
Medicaid
Medicaid is a joint federal and state program designed to provide healthcare coverage to low-income individuals and families. Eligibility and benefits vary from state to state, but it often serves as a vital safety net for individuals who are unemployed and have limited financial resources. Here’s a more in-depth look at Medicaid and how to access it when you’re unemployed:
Income Eligibility
Medicaid eligibility is primarily based on income, household size, and other factors. In states that have expanded Medicaid under the Affordable Care Act (ACA), eligibility limits have been increased, allowing more low-income adults to qualify. However, even in non-expansion states, you may still be eligible if your income falls below the poverty level or if you meet specific criteria such as having dependent children or being pregnant.
Application Process
Applying for Medicaid typically involves contacting your state’s Medicaid office or using an online portal provided by your state’s government. The application process may require you to provide documentation of your income, assets, and other personal information. Many states also offer assistance through local social service agencies to help individuals with the application process.
Retroactive Coverage
In some cases, Medicaid coverage can be retroactive to cover medical expenses incurred up to three months before the month of your application, depending on state regulations. This can be particularly helpful if you had medical expenses before obtaining Medicaid coverage.
Benefits
Medicaid provides comprehensive healthcare coverage, including doctor’s visits, hospital stays, prescription medications, preventive care, and other essential medical services. Coverage may also include dental, vision, and mental health services, depending on your state’s Medicaid program.
Managed Care
In many states, Medicaid recipients receive their benefits through managed care organizations (MCOs). These organizations coordinate your healthcare services and provide access to a network of healthcare providers. You may be required to choose an MCO or be assigned one based on your location.
No Monthly Premiums or Low Cost
Unlike private health insurance plans, Medicaid typically does not require monthly premiums. In some cases, Medicaid recipients may be subject to nominal co-payments for certain services, but these costs are generally low, and there are often exemptions for those with limited income.
Renewal and Redetermination
Medicaid eligibility is not always permanent. You will need to periodically reapply or recertify your eligibility, typically on an annual basis. Changes in your income or household circumstances may impact your eligibility, so it’s essential to stay informed and report any changes promptly.
Additional Services
Some states offer optional Medicaid programs that provide additional services, such as home and community-based services for individuals with disabilities or long-term care needs. These programs can be particularly beneficial for those who require specialized care.
Health Insurance Marketplace
The Health Insurance Marketplace, often known as the Affordable Care Act (ACA) Exchange, is a website where individuals and families may compare and purchase health insurance plans. It is a great resource for those who are unemployed or experiencing financial difficulties, since it provides a variety of solutions designed to give reasonable and comprehensive coverage. The Health Insurance Marketplace includes an annual Open Enrollment Period, during which you can apply for or alter your coverage. Typically, this time lasts from November 1st to December 15th, though particular dates may vary from year to year. It is critical to record these dates on your calendar and take advantage of this opportunity to obtain health insurance.
In addition to the Open Enrollment Period, Special Enrollment Periods (SEPs) are triggered by certain life events, such as job loss, marriage, childbirth, or other qualifying events. If you lose your employment and employer-sponsored coverage, you have 60 days to apply for coverage through a SEP. One of the most major benefits of the Health Insurance Marketplace is the availability of subsidies. The government provides subsidies to help lower-income individuals and families afford health insurance premiums. Subsidies are classified into two types: premium tax credits and cost-sharing reductions. These subsidies can drastically lower your monthly premiums and out-of-pocket expenses, making insurance more reasonable.
All Marketplace plans must provide basic health benefits like preventative care, prescription medications, maternity care, mental health services, and more. This ensures that you have adequate coverage for all necessary medical procedures. The Marketplace website offers tools and resources for comparing various health insurance plans based on characteristics such as premiums, deductibles, co-payments, and provider networks. You can refine your search to locate plans that match your healthcare choices.
State-Specific Programs
In addition to Medicaid and the Health Insurance Marketplace, many states provide their own health insurance programs for low-income or unemployed individuals and families. These programs differ greatly per state, both in terms of eligibility requirements and services offered. These programs have various names in different states, such as “Basic Health Program,” “State Children’s Health Insurance Program (SCHIP),” or “State-specific Health Coverage Program.” Each state has the freedom to create its own program to meet the specific healthcare needs of its citizens.
Eligibility for state-specific programs is typically based on income, and the requirements vary by state. Some programs cater to certain demographics, such as children, pregnant mothers, or people with impairments, while others accept a larger variety of applicants. Job loss and unemployment are common variables that improve your chances of qualifying. State-specific programs offer a variety of healthcare services, including doctor visits, hospitalization, preventive care, prescription drugs, and more. Some states may additionally provide extra benefits like dental and vision care, mental health services, and substance addiction treatment.
To apply for these programs, contact your state’s Department of Health or the organization in charge of managing healthcare programs. Online applications are frequently accessible, making it easy to apply from the convenience of your own home. You may be required to supply evidence proving your income, citizenship or residency status, and other relevant information. Some state-specific schemes may have minimal or no monthly premiums, while others may impose small fees or co-payments for specified services. The cost-sharing arrangement varies, but the overall purpose is to make healthcare cheap for individuals with limited resources.
Spouse or Family Coverage
One potential option for obtaining health insurance when you’re unemployed is to explore coverage through a spouse or family member’s employer-sponsored plan. This approach allows you to become a dependent on their policy, granting you access to healthcare benefits. The availability of spouse or family coverage largely depends on the policies of your spouse or family member’s employer. In most cases, employers offer the option for employees to include their spouses and dependent children on their health insurance plans. Some employers extend this benefit to domestic partners as well.
In addition to the regular open enrollment period, many employer-sponsored plans offer special enrollment periods (SEPs) triggered by qualifying life events. These events can include marriage, the birth or adoption of a child, or a spouse’s job loss. If you’ve recently lost your job, you may be eligible to enroll in your spouse’s plan during a SEP. Enrolling in a spouse or family member’s plan typically involves sharing the cost of premiums. The employer and the covered employee typically contribute a portion of the premium cost, while the dependent (you, in this case) is responsible for any additional premiums. It’s essential to understand the financial implications and budget accordingly.
The specific benefits and coverage options offered by the employer’s plan may vary. Review the plan’s coverage details carefully to ensure that it meets your healthcare needs. Consider factors such as the network of healthcare providers, prescription drug coverage, and any deductibles or copayments associated with the plan.
Short-Term Health Insurance
Short-term health insurance plans, sometimes known as temporary health insurance, are intended to provide coverage for a limited time, usually ranging from a few months to a year. They can be a solution for people who are unemployed or in between jobs but require some type of coverage. Short-term health insurance plans are temporary in nature, and their lifespan varies depending on the insurer and state restrictions. While they can give coverage for up to a year in specific situations, the majority of states limit it to three to six months. Be warned that these plans often do not provide as much coverage as long-term health insurance options.
Short-term plans are designed to provide basic, essential coverage and are typically less extensive than standard health insurance. They may exclude pre-existing conditions, maternity care, mental health services, preventive care, and prescription medications. Before enrolling, make sure to carefully review the plan’s advantages and limitations. Short-term plans do not meet the Affordable Care Act’s (ACA) minimum essential coverage criteria. This means that even if you just have a short-term plan, you may be subject to the ACA’s individual mandate penalty (if applicable in your state) for not obtaining complete health insurance.
State Regulations For Short Term Plans
Each state has its own set of rules governing short-term plans. In reality, some jurisdictions prohibit residents from purchasing these plans, although the majority allow for a limited time to have one. The following states enable you to get short-term coverage for 364 days and can renew up to three times for a total of three years:
For more in-depth information on your state’s laws surrounding short term insurance, check out our state-by-state guides to health insurance.
Non-Profit and Community Resources
In addition to government programs and traditional health insurance options, there are non-profit organizations and community resources that offer assistance to individuals who are unemployed or facing financial hardship. These resources can provide valuable support in accessing healthcare coverage and essential medical services.
Community Health Centers
Community health centers, also known as Federally Qualified Health Centers (FQHCs), serve as primary healthcare providers for underserved populations. They offer a wide range of healthcare services, including medical, dental, and behavioral health services, often on a sliding fee scale based on income. These centers are essential for individuals without insurance or with limited resources.
Free Clinics
Many communities have free or low-cost clinics staffed by volunteer healthcare professionals. These clinics provide basic medical care, preventive services, and sometimes prescription medications at little to no cost. They are a valuable resource for individuals who may not have insurance coverage.
Non-Profit Health Organizations
Various non-profit organizations, such as the American Cancer Society, American Heart Association, and American Diabetes Association, may offer financial assistance programs or resources to help individuals access necessary medical care. These programs may focus on specific health conditions and offer support for related expenses.
Prescription Assistance Programs
Some non-profit organizations and pharmaceutical companies offer prescription assistance programs for individuals who cannot afford their medications. These programs provide discounts or free medications to eligible individuals based on income and other criteria.
Navigators and Enrollment Assistance
Non-profit organizations and community groups often have trained navigators or certified application counselors who can assist individuals in navigating the health insurance enrollment process. They can help you understand your options, complete applications for government programs like Medicaid or the Health Insurance Marketplace, and provide guidance on available resources.
Local Social Services Agencies
Local government social services agencies can connect individuals with a range of resources, including healthcare coverage options, food assistance, housing support, and more. They can assess your eligibility for programs like Medicaid and provide guidance on accessing community resources.
Disease-Specific Support Organizations
If you have a specific medical condition or are dealing with a chronic illness, consider reaching out to disease-specific support organizations. These organizations often provide educational resources, financial assistance, and support networks to individuals and their families.
Charitable Foundations
Some charitable foundations and philanthropic organizations provide grants or financial assistance to individuals in need of medical care or health insurance coverage. These grants may be available on a case-by-case basis and can help cover medical expenses or insurance premiums.
Local Churches and Religious Organizations
Religious institutions and local churches may offer support programs, including healthcare assistance, to members of their community. Reach out to local congregations or organizations to inquire about available resources.
Conclusion
Losing a job can be a challenging time, but it’s essential not to overlook the importance of maintaining access to healthcare. By exploring the various options available, such as COBRA coverage, Medicaid, the Health Insurance Marketplace, and state-specific programs, you can find a solution that suits your needs and budget. Don’t hesitate to seek guidance from healthcare professionals or social service organizations to help you navigate the process and secure the health insurance coverage you need during this transitional period. There is a way to get affordable health insurance without all the hassle. A licensed EZ insurance agent can outline the benefits and drawbacks of each plan. And assist you in creating the plan that will work best for you.
Working with an agent saves you time and stress, no more trying to decode legal jargon or reading fine print. Agents do all the heavy lifting while you rest easy knowing that your coverage will be the best fit for your financial and medical needs. Not to mention EZ agents can save you hundreds of dollars every year on health insurance premiums.
We do this by having the ability to search both on and off market for the most affordable plans. We’re also able to find and apply any discounts you may qualify for. And we don’t stop at just finding you a plan, we help maintain your plan after the fact too! We can help you file claims with your provider and even help renew your policy when the time comes. To get started, simply put your zip code into the box below or give one of our licensed agents a call at 877-670-3557.
Americans can make changes to their health insurance plans every year starting on November 1st. It’s important to take advantage of this because a lot can happen in your life over the course of a year. Like having a child, getting married, or changing jobs. All of which could mean that you need to change your health insurance plan. But what if you haven’t gone through any big changes? Do you have to sign up for a new health plan every year? It depends. If you’re happy with your current plan, you might decide to do nothing at all during the Open Enrollment Period. On the other hand, if you’re not happy or aren’t sure if you should make changes, doing nothing can have some costly consequences.
Getting Stuck In Your Current Plan
If you’re happy with your current plan, this may not necessarily be a negative thing for you. However, if your plan isn’t meeting your needs and you miss the Open Enrollment Period, you’re going to be locked in for another year until the next Open Enrollment Period. If you don’t take the opportunity to review your current plan and do nothing during the Open Enrollment Period, you won’t be able to change your plan. What this really means is that your health insurance might:
Not provide enough protection for the coming year, which will result in additional costs.
Include coverages that you don’t actually require, which would mean that you’d be paying for protection that you wouldn’t use.
Be too expensive. If you don’t change your plan during the Open Enrollment Period, you’ll be stuck with the higher rates and costs.
Inability To Get Health Insurance
The Open Enrollment Period is for people without health insurance to enroll. For example, adults who just turned 26 and have to get off their parent’s coverage. If you miss this opportunity, you may not be able to enroll at all until the next Open Enrollment Period. Without health insurance, you may have to pay for your medical expenses out-of-pocket. Which can be financially difficult especially for major medical procedures or ongoing treatments. Missing the Open Enrollment Period can lead to delayed or inadequate healthcare, potentially impacting your overall health and well-being.
You Could Face Tax Penalties
At first, the Affordable Care Act did have a penalty in place for missing the Open Enrollment Period. Anyone who could get cheap health insurance, but didn’t sign up had to pay a fine every year. The federal fine was taken away, though, in 2018. However, California, Massachusetts, New Jersey, and Rhode Island all have their own rules that penalize people who don’t have health insurance. The amount of the fine depends on your income level and the tax rules in that state.
Less Options
If you don’t have health insurance and want to sign up for a plan, but you don’t do anything during the Open Enrollment Period, you won’t be able to get a Marketplace or exchange health insurance plan, or an ACA-compliant health plan. Even if you miss the Open Enrollment Period, you do have other choices. But you should know that there are only a few options and they come with limits.
Special Enrollment Period
Outside of the Open Enrollment Period, one of the only ways to get a reasonable health insurance plan that complies with the ACA is to be eligible for a Special Enrollment Period. People can only use a Special Enrollment Period if they have a qualified life event, such as:
Marriage – If you get married, you can choose a new plan by the last day of the month. And service will start the first day of the next month.
Children – If you give birth, adopt, or foster a child you can enroll within 60 days of the event and coverage would backdate to the day of the event.
Moving – You are eligible for a Special Enrollment Period if you moved to a new ZIP code or came to the U.S. from another country. You are also eligible if you moved to or from school, a place where you live and work seasonally, a shelter, or other temporary housing.
Losing Coverage – Losing your current health insurance plan due to a divorce, quitting a job, losing coverage through a family member, or losing Medicaid eligibility, qualifies for coverage during a Special Enrollment Period that lasts for 60 days after you lose coverage (or, in some states, 60 days before you lose coverage). After you choose a plan, your plan will start on the first of the following month.
Those are the main events that trigger a Special Enrollment Period, but there are other circumstances. For example, you can get special enrollment if you became a U.S. citizen, got out of jail, or finished a certain service program. If you were hurt or couldn’t sign up because of a FEMA-designated natural disaster, like COVID-19, you have 60 days after the end of the disaster to sign up for a Marketplace plan. Incapacitation can happen if you have a temporary mental condition or if you are in the hospital during open enrollment. You can ask for your plan to start when it would have, if the event hadn’t happened.
Also, if you weren’t able to enroll or get the help you were eligible for because someone helping you did something wrong, gave you bad information, lied to you, didn’t do anything, or because of a technical error, you are eligible for a special enrollment time.
Exceptions
There are a few people who have different rules for the Special Enrollment Period. Native Americans can sign up for a health plan through the exchange at any time, without having a qualifying event. People whose household income is less than 150% of the government poverty level can sign up for health insurance at a special rate until at least 2025. The Basic Health Program covers people who live in New York or Minnesota and don’t make more than 200% of the poverty level all year long. Oregon wants to have a Basic Health Program by the middle of 2024. Like New York and Minnesota, Oregon would let people sign up for the program at any time of the year.
Why You Need To Use The Open Enrollment Period
The last few years have been, to say the least, unpredictable. Covid-19 has caused hundreds of thousands of illnesses and deaths. As well as job loss and financial problems that many people even now, two years later, are still recovering from. As a consequence, it’s more important than ever to make sure you and your family are protected. Now is the time to do that. The Open Enrollment Period for the Affordable Care Act is here, which means you can find a great plan or change the one you already have. Don’t put it off, especially since you need to pay attention to the Open Enrollment Period this year for so many reasons.
More Options
One of the most important reasons to shop around during the Open Enrollment Period is that you might not know about all the plans and savings choices that are available to you. The Affordable Care Act (ACA) is always changing and growing. As a result, more Americans now have health insurance than ever before. This is because more people can get subsidies and some health insurance companies are expanding into new areas and giving new plans all over the country. That means you have more choices than you did before. So, you might be able to find a better, cheaper health insurance plan that covers you better.
Health Insurance is Necessary
The outbreak showed just how important it is to have health insurance. Even though the Covid-19 situation is over, what if you or someone you care about needs to go to the hospital? Without insurance, you or a member of your family could get hospital bills for Covid. Or any other illness that you or they were treated for. This could put you tens of thousands of dollars in debt. If you had the right health insurance, you could avoid that. Also, what if, like millions of other Americans, you lost your job? If you did, you probably lost your health benefits along with your job. However, just because you lost your job doesn’t mean you can’t still find cheap health insurance with the help of an EZ agent.
Don’t Wait
Look at plans! There’s no reason not to check out your options and compare plans before the Open Enrollment Period ends. But we know that researching all the different plans can be a pain, so we’re here to help! Our competent agents will talk with you and explain all of your choices in detail. When you’re ready to sign up, they’ll look through all the plans in your area to find the best one for you. Making sure it meets your needs and fits your budget. You will always have your own personal agent with EZ. So you don’t have to worry about jumping from agent to agent or getting a lot of sales calls. Not to mention all of our services are FREE. Enter your zip code in the box below to start. Or call 877-670-3557 to talk to an agent right away.
When enrolled in a Marketplace Insurance plan, it is important to make sure your household information is up to date every year. There may be benefits you are missing out on and possible consequences if you do not update.
What Changes To Report
Changes to your income for the year, whether a raise or demotion
Changes in health coverage: Whether someone in the household is getting job-based insurance, and/or receiving public coverage such as Medicaid, CHIP, or Medicare. Also, if someone is losing coverage that is job-based or public.
Changes to your household or individual members: If there is a birth or adoption, placement of a child for adoption or foster care. If someone becomes pregnant, and/or getting married or divorced. Child turning 26 years old. If there is a death, gaining or losing a dependent, and if you are moving to a permanent address.
Make sure names, date of births, and Social Security numbers are correct
Changes in status: Such as disability status, tax filing status, change in citizenship, whether there is American Indian member, and/or incarceration or released from incarceration.
Why You Should Report The Changes
If your income goes down or you gain a household member, then you may qualify for more saving than you are currently receiving. This can lower your monthly premium payments.
The flip side is if your income goes up or you lose a household member, then you could qualify for fewer savings. If you do not report this change, it will result in owing money when you file your federal tax return.
How To Update
Who you will contact for help is dependent on whether you got your plan from the Marketplace, or from a provider such as EZ.Insure. If you got a plan from one of our agents, you can always call 855-220-1144, or email us at [email protected] to speak to your agent and update your information.
You can report any change by updating your application online after logging into your account on Healthcare.gov. Click on your application, choose “report a life change,” and then save it when done.
Contact a representative at the Marketplace Call Center at 1-800-318-2596. Or call your advisor at EZ.Insure.
If you move to a different state, log onto your account in HealthCare.gov, select a new application; select the year for coverage, and the new state. Finally, choose “apply or renew” to start a new application.
If you are switching to a job-based insurance plan, or to Medicare, make sure to cancel your current plan.
Do not forget to update your 2018 information, because it can cost you in the end when you file your federal tax return. And more importantly, you can possibly lose out on extra savings you should be receiving!
If you are looking for a new plan or have questions regarding your coverage, EZ.Insure can help. Our agents specialize in short term plans in your area and can answer any questions you have to find out if it is right for you. You will be given your own advisor who will go over different plans, and help sign you up free of charge. To start saving, enter your zip code in the bar above to get instant quotes, email us at [email protected], or call 855-220-1144. We guarantee we will be able to find you a plan that is affordable and meets your needs.
