COVID-19 has taken a global status and officially been declared as a wide-scale pandemic by the World Health Organization. With governments taking acute measures, imposing lockdowns and closing borders, we still don’t know how the crisis will develop.
Apart from the tragic human toll, the one thing that has shaken the masses is the uncertainty. COVID-19 has posed some serious risks to everyone’s health and wellbeing. But it has also left many people hanging in the air when it comes to job security.
With businesses closing down and financial losses on the rise, several companies are on the verge of laying off their employees. This year, nearly 22 million Americans have been laid off or lost their jobs around states and cities due to the coronavirus.
As outrageous and unethical as it is, now is the time to face the crisis head-on.
Whether you’ve been recently laid off or are dreading a possibility, seeking new health coverage is crucial. Companies offer a wide array of policies that may continue health coverage for up to a month after laying off their staff.
However, the fear of life and financial burdens brought on by COVID-19 are too real to ignore. The pandemic has pushed many companies to close their doors. Unemployment at the time of a health crisis can be extremely challenging.
Workers are now increasingly looking for other options to secure their healthcare plan. Lack of insurance could mean that people may have to put up with catastrophic medical costs. With rising questions and fears, here are some key things you need to know about new health coverage and COVID -19.
How to Get New Health Coverage in the Time of COVID-19 Pandemic
Temporary Emergency Program for COVID-19
A special letter sent to Congress demands an emergency mitigation program to tackle the health risks of COVID-19. It requires all health insurance providers to cover COVID-19 testing services and related treatments.
However, this is a temporary contingency plan that will be put into action if the real-world insurance costs are extraordinarily high. The program will, therefore, be covering COVID-19 related costs from 2020-2021 and apply them to Medicaid markets, the individual in question and the employer.
So, if you’re wondering whether your health insurance covers COVID-19, then certainly, it does. However, if you’ve been laid off, you need to look for new health coverage to secure yourself and your family.
Covering the Basics
Before we step into this discussion, there’s one incredibly important thing you need to do when you get laid off – inquire about your health insurance benefit. If you’re well aware of what terms and policies you’re leaving the company with, then good for you.
If not, this is a critical time to find out how long you will be covered under the employer-sponsored plan. In most cases, employers may pay a month prior to laying off their staff. This is good news for those laid off early but not so much for those who have been broken the news at the very end.
In either case, have a meeting with your HR manager and get all the options, the current status, and other details about your health insurance clarified. Stepping out without health insurance is risky for sure. However, here are some options you can consider.
If the company has laid off 20 or more employees at once, the Consolidated Omnibus Budget Reconciliation Act (COBRA) allows you and your family the benefit to continue coverage that goes up to 18 months.
This policy allows an unemployed person to continue receiving the same benefits as they were getting from their employer. So, as long as you’re covered by any other healthcare plan, COBRA is a plausible option.
The conditions apply when you have to leave your job due to unforeseen circumstances, in this case, COVID-19. Any reason except for “gross misconduct” can make you eligible for coverage up for to 18 months.
However, you will have to pay the full premium, which can be equal to 102% of the plan’s cost. You’ll be retaining the coverage on group insurance rates; however, the premium will be hefty. You’ll have to pay back both the employer and the employee’s costs along with an administrative fee.
This will eventually drive up the final costs of the plan. However, taking into account the serious threats of COVID-19, applying for COBRA might still be better than living without any coverage. If you are considering COBRA, you’ll be given 60 days to choose COBRA health coverage after leaving your job or working on a reduced number of hours.
If your insurance plan also covered your immediate family, like your spouse and kids, then COBRA will also provide you the same coverage. To opt for COBRA, you can contact the insurance company directly or the employer’s insurance administrator. However, if you think this is an expensive option, there are other cheaper alternatives to pursue.
2. Health Benefits under the Affordable Care Act
As per the Affordable Care Act (ACA), anyone who loses a job along with their health insurance is entitled to a special enrollment period. ACA is responsible for establishing the Health Insurance Marketplace. To find out your options, you can begin your search by visiting HealthCare.gov. In case you’re eligible for Medicaid or a premium subsidy, you might not have to opt for COBRA.
Under ACA, employees who have been laid off can shop for a separate health care plan on federal or state exchanges. If you’re not receiving active income, you can be qualified for substantial government subsidy.
The original time frame to apply for this coverage runs from 1st November – 15th December 2020. However, at this point, you might not have to worry about open enrollment time, as you can apply mid-year. Losing your job due to COVID-19 can be counted as an unforeseen situation that gives you the benefit of applying immediately.
In fact, you can apply on the first day of the month right after you lose your job-based coverage. While filling the application, you’ll be able to find out if you’re eligible for out-of-pocket healthcare costs and savings on your monthly premiums. Both of these factors will be based on your income.
The procedure to elect marketplace coverage is quite simple. You need to submit an application with your estimated income while you were employed as well as details about your spouse and family members who are dependent on you. The website will then show you different health plans that fit your budget and personal needs.
At this point, you might be calculating your premium costs, hospital costs, and copayments that are part of the plan. In the light of COVID-19, to get a rough estimate of how much you could end up paying, simply add up your out-of-pocket maximum and total annual premium on the health coverage. The amount you get will be how much you need to pay up when the worst-case scenario strikes.
In total, eleven US states and the District of Columbia are offering a special enrollment period due to the pandemic. You can check out Healthcare.gov to make a note of the deadlines and take up this opportunity. However, if you don’t live in any of these states, seeking marketplace coverage may not be easy.
With this notable letter sent to Congress, the US federal government has been requested to allow access to a one-time special enrollment period without any need for qualifications. Marketplace coverage can’t deny individual coverage, which is an important benefit if you want to avail emergency services or get tested for COVID-19. The plan will at least cover the ten healthcare benefits offered by the federal government.
3. Medicaid Coverage
If you have Medicaid coverage, make sure to keep your enrollment status is fully updated. This way, there won’t be any chances of losing coverage in case you forget to re-enroll. If you don’t have healthcare insurance, there are still a few options left to explore.
As far as Medicaid is concerned, you might be eligible if your personal income is currently below $17,236 or less than $35,535 for a family. The good thing about Medicaid is that it’s open year-round and the eligibility mainly depends on your current monthly income. With Medicaid, testing for the virus will be covered without any cost-sharing.
However, whether or not you qualify for Medicaid depends on where you live. Connecticut is one of the 37 states that have expanded their eligibility for Medicaid. If you’re a resident, you can get the benefits that your income is below 138% of the FPL (federal poverty level).
4. Private Insurance and Coronavirus Coverage
According to the Families Front Coronavirus Response Act recently passed by Congress, if you have private insurance, your insurer has to cover all the medical tests and related services without any cost-sharing. The bill was passed into law on March 18, 2020. It includes a 14-day paid leave for US employees who have been affected by the coronavirus.
This will typically include visiting the doctor’s office, emergency room, or urgent care center for COVID-19 testing. A greater number of US states are finally realizing the importance of protecting American workers.
Coverage for Hospitalization and Quarantine
According to the plan, patients who are either quarantined or hospitalized will receive the same benefits as other patients in the medical facility. It’s important to understand that the plan will cover lab tests, doctor visits, and support therapy for treating the symptoms of the infection.
However, whether or not treatment costs are covered will depend on your individual ACA-compliant plan or short-term plan
Temporary insurance can be purchased for 30 days or even longer depending on your state. You’re eligible if you’re under 65. The plan will typically cover the treatments and services like hospital stays, emergency room visits, and lab tests related to COVID-19.
Short-term coverage is a reasonable option until the time you can’t elect ACA-compliant coverage for COVID-19. However, deductibles are likely to shoot up when it comes to private insurance. How much you end up paying will depend on your insurer, which is why it’s important to choose an experienced insurer with financial strength.
However, if you’re buying your own coverage, be careful when considering a short-term health insurance plan. This is because such plans may be short-sighted for a sweeping pandemic like coronavirus. There is a lot that comes under the essential coverage for COVID-19, which might not be included in your plan.
5. Spouse’s Insurance
For those who are married, your spouse’s insurance could come in handy. This is, of course, if the company they’re working in is continuing its operations through work-from-home options or telework.
If their company offers health insurance, you’re probably included in the coverage. If so, make sure to maximize on the limited enrollment period concerning tests and treatment related to COVID-19. They may be offering those services to their workers.
Although most healthcare plans only accept married couples, a rising number of private employers may also ask domestic partners to seek coverage. Whether or not this benefit is offered in Connecticut will depend on the specific insurance company you’ve contacted.
5. Parents’ Health Insurance
Being young can make you lucky in many ways. If you’re aged under 26 and have parents whose coverage includes dependents, you might be able to seek the benefits under a special enrollment period.
For job-based plans, your parents can check with their employers to better understand the nature of benefits. If the healthcare plan has been sought through the Marketplace, then ask your parents to include you when they’re filling the application for a special enrollment period.
A Final Word
Anyone who has lived without health insurance in the US will know how risky and dangerous it can be. If you’re not insured, you might have to pay up catastrophic costs to be tested and treated for COVID-19. While the situation is dire, there is still a lot you can do to get new health coverage.
Evaluate your options mentioned above to find the most feasible option that fits your budget, family, and health care needs. For further guidance new health coverage and COVID-19, get in touch with Pawson Insurance!
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