Understanding health insurance options

It’s important to understand your health insurance options if newly unemployed. (copyright fizkes/iStock via Getty Images Plus)

Understanding health insurance options

(StatePoint) With millions of people nationwide filing for unemployment since the start of the COVID-19 pandemic, many individuals and families across the country are suddenly finding themselves without health insurance at a precarious time. Fortunately, new options may be able to help those on tight budgets.

“The sudden and unexpected loss of health insurance only compounds the stress caused by job loss amidst this unprecedented economic and public health crisis. However, unemployed individuals have more options for affordable health insurance than they did during past economic recessions thanks to provisions in the Affordable Care Act, along with actions recently taken by Congress and some states,” says American Medical Association (AMA) President Patrice A. Harris, M.D.

Whether you recently lost your job-based health insurance or were uninsured before COVID-19 struck, the AMA, a long-time advocate for health insurance coverage for all Americans, is highlighting the following options:

• Affordable Care Act (ACA) Marketplaces: Family and individual health plans can be bought in the health insurance marketplaces created by the ACA. Losing a job is a qualifying life event that allows unemployed individuals up to 60 days to enroll in a marketplace health plan before the close of a special enrollment period. Due to the COVID-19 pandemic, certain states have reopened enrollment periods when all consumers – not only those who have experienced a job loss – can enroll in marketplace health plans and potentially qualify for financial assistance to purchase these plans based on their income.

Subsidies available to eligible individuals through the health insurance marketplaces can help with premiums and out-of-pocket costs, making coverage more affordable. The Kaiser Family Foundation can help calculate an estimate of premiums and subsidies based on an individual’s income, age and family size. It will also estimate an individual’s eligibility for Medicaid.

• Medicaid: While each state’s program has unique attributes for coverage, Medicaid can offer no- or low-cost coverage for those with the lowest incomes with limited cost-sharing requirements. Unlike the ACA marketplaces, there is no defined open enrollment period for Medicaid, and eligible people can sign up at any time. State eligibility requirements and income qualifications vary by state. Every state covers low-income children, pregnant women and people with disabilities, while 36 states and the District of Columbia have expanded Medicaid coverage so that adults with income up to 138 percent of the federal poverty level can qualify.

• Beware short-term plans: The AMA cautions patients to avoid short-term limited duration plans whenever possible, especially during this pandemic. Short-term plans are designed to fill temporary gaps in health insurance when comprehensive coverage may not be an option. But it is important to understand that these plans offer very limited benefits and do not usually cover COVID-19 testing and treatment, preexisting medical conditions, mental health services, prescription drugs, and preventative and wellness care.

“Avoiding gaps in coverage should be a top priority for anyone who has recently lost their health insurance,” Harris says. “The COVID-19 pandemic has highlighted the importance of having meaningful health insurance coverage.”