Millions of people have lost their jobs due to the COVID-19 pandemic, and with it their employer-provided health insurance.
Insurance may not be the first thing you think about when you lose your job, but it’s important to act fast. There are critical deadlines you’ll have to meet when signing up for a new plan and possibly financial penalties for coming in late.
In this episode of San Diego Health, host Susan Taylor and guest Shawn Forrester, corporate vice president of payer relations at Scripps Health, discuss affordable health care options for the unemployed and underemployed, including COBRA, Medicare, and plans through the state exchange, Covered California.
Health insurance may not be the first thing you think about when you lose your job, but I do want to stress how important it is, especially during the middle of the pandemic.
There are some critical deadlines that you’ll need to be aware of. There could also be financial penalties if you don’t sign up for health insurance during those deadlines.
COBRA is a federal law that says employers must offer a continuation of the insurance that was offered to you through your employer. The way that would work is you have an initial 18-month period, and then at a later date, if you want to continue that plan even further, you can extend it for another 36 months.
What you need to be critically aware about COBRA is that it is probably your most expensive option. While you were employed and on the employer’s health insurance, most likely your employer was absorbing most of the monthly premium for that insurance. You very likely had some share in that. When you continue that insurance through COBRA, your employer may or may not continue to subsidize that cost. If you had an employer that chooses not to subsidize that cost, your monthly premium that you pay may quadruple.
If your spouse or domestic partner has coverage through their employer, you can elect to go on that. That will not be free of charge, but that’s an option for you. If you’re 26 years old or less, you could possibly go on your parents’ plan as well.
COBRA is not an enrollment process. What happens with COBRA is your employer gives you a package that explains what is being offered to you. Generally, this is the same coverage you have when you were employed through your employer. The good part about that is you’re not going to have to change health plans or physicians.
It’s not your only option when you’re concerned with continuation of coverage. In Covered California, you may be eligible for financial assistance for their insurance options as well. In order to qualify for financial insurance, you will have to be between 138% and 400% of the Federal Poverty Level.
In Covered California, as I said, it’s up to 400% of the Federal Poverty Level in order to have federal subsidies. There are multiple levels tiers. But if you’re a single person, it’s $74,940. That would be the cutoff level in 2020. For a family of four, that would be an income of $154,500. These are subject to change in future years.
Covered California is the state-run public exchange for health insurance. You can go to their website or you can call them. Most people go to their website. Once there, you will need to answer several questions. To get started, go to coveredca.com, click Get Coverage, then click Shop and Compare, and then you’re off and running. You’ll be able to see the costs that you would need to pay for all the various plan options that Covered California has on its website.
Scripps generally participates in Covered California through two health plans. One is Health Net, a plan called CommunityCare HMO. That happens to be the least expensive plan option in 2020 and in 2021 on the bronze level. The other health plan is Blue Shield, which is offering both an HMO plan and a PPO plan.
No, you cannot. There is a 60-day window in your qualifying period. Once during the year, there’s an open enrollment period for Covered California. That runs from October 15 through January 31 of each year. Sometimes, like in 2020 due to the pandemic, that period can be extended through a special enrollment period, but you can’t count on that every single year. That’s only in special events.
Absolutely. In fact, if you’re over 65, chances are you already have Medicare Part A, but when you lose your job, you’ll need to sign up for Medicare Part B. You will have eight months in which to do that. If you don’t do that in those eight months and you don’t gain other employment, then you may incur penalties. You’re going to want to research that thoroughly directly with Medicare. Medicare has an open enrollment period every year. And that runs from October 15 through December 7. During that period, you can change your health plans, you can change your coverage. You’re open to select whatever Medicare plan option is out there.
That’s right. You have to qualify for this. Your income level must be less than 138% of the Federal Poverty Level. But the good news is there is no enrollment period. You can sign up for this anytime during the year. And you can do that by going to the Health and Human Services department in San Diego in person. You could also sign up for that through Covered California, coveredca.com, or just call Covered California, 1-800-300-1506.
We’re happy to answer any questions that you have. We certainly want to make sure that we can continue to see you in your time of need. So please let us help you.