Lost your job in the wake of the coronavirus outbreak? You're not alone. 10 million individuals have filed for unemployment in the last two weeks alone and about half of the U.S. workforce depends on employer-sponsored health plans for their coverage. While you sort through the recent stimulus package to see what's in it for you (better unemployment benefits, checks for individuals, and possibly even tax credits for your employers to take you back on), you'll want to add choosing a health insurance plan to your to do list. Now is not the time to skip that one.
If you can't easily add yourself to your spouse's health plan or your parents' plan (only if you are 26 or younger), that means you are going to have to go shopping for a health plan.
What happens if I don't have health insurance and I need to be treated for coronavirus?
While testing is covered, if you require inpatient care for coronavirus, you can expect to pay anywhere from $42,486 to $74,310 if you are uninsured or if you receive care out-of-network, according to recent analysis by independent nonprofit FAIR Health. That is not a bill anyone wants to receive. While President Trump recently announced that part of the stimulus package would pay hospitals to treat uninsured coronavirus patients, this doesn't seem like a good gamble to take and isn't available everywhere (nor has it been implemented yet).
Do I have to wait for open enrollment to choose a plan?
For those of you who have recently lost your jobs (and your health insurance) due to coronavirus, you should qualify for a Special Enrollment Period (SEP), as loss of employer sponsored health insurance is a qualifying event for an SEP. You might need to submit documentation for this like a letter from your former employer or your COBRA coverage notification to confirm your loss of coverage. If you lost your HRA reimbursements because of coronavirus (through QSEHRA or ICHRA), this also qualifies for an SEP, one you should take advantage of to reconfigure potential tax credits. You will have 60 days from the qualifying event to choose a plan, so don't sit on this too long.
If you don't qualify for an SEP, there's hope in certain states. While President Trump has resisted pressures to open up all states, some states directed state-regulated health insurer carriers to waive any copayments or deductibles for patients who need tests for the coronavirus. Eleven states plus the District of Columbia have opened their exchanges, including California, Colorado, Connecticut, Idaho, Maryland, Massachusetts, Minnesota, Nevada, New York, Rhode Island, Vermont, and Washington. For those of you who have lost your health insurance due to COVID-19 and find yourselves in need of a plan outside of the regular open enrollment time period, this measure gives you access to more qualified health plans that meet minimum essential coverage.
Regardless of if you live in one of those states or not, or whether you qualify for an SEP or not, here are your options if you need to sign up for a health plan due to loss of coverage in the wake of the COVID-19 pandemic.
- Sign up for an individual health plan on Healthcare.gov if you've qualified for a special enrollment period due to loss of employer sponsored health coverage
- Sign up for an individual health plan on your state's exchange if you live in one of the states. that have opened exchanges (see above).
- Sharing ministries
- Short-term plans
- We will dive in to what all of this means in the next sections.
So what is COBRA exactly?
When you're researching your best bets for health insurance if you've lost your health insurance due to coronavirus, COBRA may sound like a great opportunity to avoid a coverage gap, and in such a confusing marketplace, it may seem like the best option.
COBRA, or the Consolidated Omnibus Reconciliation Act, is a temporary coverage option provided to individuals and their families who are no longer eligible for a Group Healthcare plan. This happens after a Qualifying Event—in this case, losing your job due to layoffs tied to the coronavirus pandemic.
Think twice before choosing COBRA
COBRA may sound like a hassle-free option that provides the same coverage and the same doctors as your previous plan.
The truth is that COBRA is way more expensive to you than your Group Healthcare Plan because you are now responsible for paying the portion your employer was paying plus your portion for the same amount of coverage.
Once you elect for coverage under COBRA, the full amount of that cost can be charged to you as an individual. You can be billed for up to 102% of the total cost of coverage; 100% of the cost of your previous plan plus a 2% administrative fee.
There are a few scenarios where COBRA actually makes sense. If you’ve already spent your deductible or max out of pocket for the year and expect to continue receiving care. In this scenario, paying a little more for the COBRA premiums will probably keep your cost of care down versus starting a new deductible. If you take a prescription that is only available on your group plan and there’s no alternative your doctor can prescribe, this is a very rare scenario in which COBRA would be best. If you regularly see a specialist who accepts your group plan, and subsequently will accept COBRA, but does not accept any individual plans available, then COBRA is worth considering.
Don't stress. There are better options other than COBRA!
Let's jump in.
Best health insurance options if you've lost coverage due to COVID-19
Instead of finding out too late that COBRA falls short, find a healthcare plan that fits you and your families’ individual needs. Our data-based platform on our website can help you sort out these options and compare plans side by side, and we can help you calculate subsidies and tax-credits as well.
Take Command Health can help you explore three options besides COBRA:
1. Individual Medical Plans: Again, if you can access the state exchanges in your state or if you qualify for a special enrollment period, this is a great option. There are two different types of individual medical plans; On-Exchange or Off-Exchange. On-Exchange plans are found on Healthcare.gov and are eligible for tax-credits and subsidies. Off-exchange plans are not on Healthcare.gov and are not eligible for tax-credits or subsidies. However, the cost of these plans is often comparable, and an off-exchange plan can include larger doctor networks and more features.
Some carriers are doing a better job of offering coverage and support through this COVID-19 pandemic; be vigilant about researching how your carrier options are handling the situation.
Some carriers have agreed to waive member cost-sharing, copays, or other fees because of coronavirus. This varies largely by carrier. To see what specific insurance carriers are doing for their members, check out this helpful link from AHIP.
Pro tip: If you purchase a marketplace plan through Healthcare.gov or state exchanges, you'll need to figure out if you are eligible for tax credits or increasing existing tax credits due to unemployment. Chat with our team on our website any time and we will walk you through how to do this.
2. Short-Term Plans: Affordable plans that can provide great coverage for specific incidents such as accidents or illness, but don't cover routine care or pre-existing conditions. These plans are exempt from covering the essential health benefits that major medical plans are required to cover under the ACA. Under the Trump administration, short term plans were lengthened to a coverage period of 364 days and renewable up to 3 years as allowed by the carrier. Read more about Pivot short term plans and UHOne Short Term plans on our blog on affordable alternatives to traditional health insurance.
If you have pre-existing conditions, or if you are more vulnerable to the coronavirus, then a short-term plan is probably a bad idea.
If you're young and just need something "just in case," then short term plans could still be a good fit in case of big emergency. If you require treatment for coronavirus, it would cover a hospital stay. Specific plan details would need to be discussed with the carrier. We would recommend adding a premier membership to your short term plan that includes Teledoc to help offset some of the downsides of short-term plans so you can access a doctor virtually before heading to your nearest clinic.
3. Faith-based plans: With more than 1,000,000 members, these plans act like insurance for people that testify and live to a Christian lifestyle. They are exempt from the healthcare laws, are often more affordable, and you can enroll year round. You can read our CEO's Medi-Share review if you want to get a better idea of how sharing ministries work.
Since sharing ministries are not considered insurance, they are exempt from having to cover COVID-19 testing. That being said, each ministry is updating its members on how they will cover testing and treatment. If you have coverage under a sharing ministry, it is best to stay up to date with their coverage terms during this time as things are being updated daily.
- MediShare: Free telemedicine visits; COVID-19 testing will be eligible for sharing after annual AHP is met; Some provider fee’s waived if you are referred by MDLIVE to ER or physician.
- Samaritan: COVID-19 tests and treatments are eligible for sharing.
- Christian Healthcare ministries: COVID-19 tests and treatments are eligible for sharing.
Understanding health insurance and coronavirus (COVID-19)
If you get coronavirus and you've signed up for a health plan, the care will be covered just the same as any other illness, as testing and medically necessary care for you would fall under what most individual plans call Essential Health Benefits, or minimum essential coverage. It also would include doctor visits, hospitalization and support therapy for the symptoms of the infection. There are no limitations and restrictions surrounding the specific condition.
But remember, treatment and diagnosis for the pandemic still brings with it out of pocket costs for the individual, not to mention the system-wide effect coronavirus will have on the health insurance market.
The best thing you can do when choosing a health plan during COVID-19 is to understand what's covered and what's not, and what your deductibles and out of pocket maximum amounts are.
If you are having trouble, call your insurance carrier and they will walk you through it. Better to know ahead of time, we always say.
Kaiser Family Foundation put together a really great guide on private health insurance coverage of COVID-19 that we found really helpful. Give it a read.
Here are a few important points to keep in mind as you shop for a health plan:
- Out of pocket costs: When individuals receive care for coronavirus, they can face out-of-pocket costs that come in the form of a co-pays, deductibles or coinsurance before coverage kicks in.
- Lab work & diagnostics: All COVID-19 testing is considered an essential health benefit.
- Telehealth: Many health insurance plans partner with Telehealth services (call your carrier to check). Teladoc, a telehealth provider, lets you call a doctor from your home and you never have to leave your couch. That also means that germs are staying at your home too. It's a great complement to social distancing and it means that you'll talk to a doctor and get care quicker than if you had to make a doctor's appointment (it's also cheaper!). We love Teladoc at Take Command Health!
What's the best plan for me?
Take Command Health is here to help you make an informed choice about what's best for you and your family. If the prices for plans are looking a little scary to you, make sure to consider all your options and price compare. Chat with us on our website and we would be happy to answer any questions!