The COVID-19 pandemic has had a major impact not only on health, but also on health insurance. As businesses close or cut back on staff, millions of Americans have lost their jobs and, as a result, their employer-provided health insurance. If you’re among them, you can still access affordable health coverage for yourself and your family. In this video, San Diego Health host Susan Taylor talks with Shawn Forrester, the corporate vice president of payer relations at Scripps Health, about your options.
If you’ve lost your job, you may be eligible for health insurance coverage under COBRA, a federal law that requires employers to offer a continuation of your insurance. COBRA allows you to keep your coverage for 18 months; at the end of that period, you can extend coverage for another 36 months. However, because your employer may no longer pay part of the premium, COBRA can be very expensive.
“While you were employed, most likely your employer was absorbing most of the monthly premium for your insurance, and you probably paid part of it,” says Forrester. “When you continue that insurance through COBRA, your employer may or may not choose to subsidize the cost. If they don’t, your cost for the monthly premium may quadruple.”
For some people, that may mean paying hundreds or even thousands of dollars more per month. However, COBRA allows you to keep your health care providers, so you do not have to change doctors or interrupt current treatment plans.
If you have a spouse or domestic partner who has employer-provided health insurance, they may add you to their coverage. You will have to pay part of the cost, but it is typically much less than COBRA coverage. Depending on the new plan, you may be able to keep your doctor, or you may have to choose a new one.
Another option is Covered California, a free service that connects Californians with health insurance under the Patient Protection and Affordable Care Act. Covered California offers several levels of coverage — Bronze, Silver, Gold and Platinum — through brand-name insurance providers, such as Blue Shield and HealthNet. The cost for each plan depends on several factors, including the deductible amount and whether you choose an HMO or a PPO.
Plus, people who meet certain household income levels can receive financial assistance from Covered California to help them pay for health insurance. In order to qualify for financial aid, your household income reported on your tax returns must be between 138% and 400% of the Federal Poverty Level. For a single person in 2020, that would be a household income between $17,609 and $74,940; for a family of four, it would range from $36,156 to $154,500. These guidelines can change every year.
To apply for Covered California, you can call 1-800-300-1506, apply on the website at coveredca.com, or go through an insurance broker who offers Covered California plans. The website offers information about all of the plans and eligibility. Click on “Shop and Compare” to review and compare plan benefits and premiums.
If you want access to Scripps doctors through Covered California, there are two plans to consider.
“One is a Health Net plan called CommunityCare HMO, which happens to be the least expensive plan option in 2020 and in 2021 on the Bronze level,” Forrester said. “The other is Blue Shield, which offers both an HMO plan and a PPO plan.”
If Covered California sounds like a good match for you, you may need to act quickly. You must enroll in a Covered California plan within 60 days of losing your health insurance, or during the annual open enrollment period that runs from October 15 through January 31 of each year.
If you’re age 65 or over, you’re eligible for Medicare. Most people over 65 already have Medicare Part A, but if you lose your employer-paid health coverage, you'll need to sign up for Medicare Part B within eight months. Medicare also has an open enrollment period every year; in 2020, that runs from October 15 through December 7. During open enrollment, you can change your Medicare plans and providers. You can find more information at medicare.gov.