How to keep your health insurance if you are fired from your job or take leave without pay

If you have been fired from your job or placed on unpaid leave, you have a lot to worry about right now. And, during the COVID-19 outbreak, healthcare is surely one of the most important. Now more than ever, comprehensive health insurance can help maintain your health and financial well-being, and give you the feeling that you are more protected.

According to Healthcare Bluebook, a website that promotes cost transparency, a “fair price” for a 30-minute visit to the doctor exceeds $200 ¹ . A broken leg can cost $7,500, and a three-day hospital stay could cost as much as $30,000 ² . Without the proper coverage, all that money comes out of your pocket.

Whether you're a laid-off employee or a business owner concerned about employees on leave without pay, there are options to keep you covered. Continue reading to find out which is the best solution for your case.

COBRA

You may have heard of “COBRA”, the Consolidated Omnibus Budget Reconciliation Act. It's a federal law meant to make sure families have insurance after they lose their jobs. Coverage is available if you are already enrolled in an employer-sponsored medical, dental or vision plan, and if your company has more than 20 employees. You generally have 60 days from losing your previous coverage to enroll, although many insurance companies (including Aetna) are extending this window during the COVID-19 crisis.

COBRA coverage is a good option if you have money saved or still have some income. The average beneficiary pays $610 per month for individual coverage or $1,750 for family coverage ³ . (Where applicable, the costs could be lower or higher.) To lower your costs, your employer may subsidize premiums for a while. Or, if you have a Health Savings Account (HSA), Health Reimbursement Arrangement (HRA), or Individual Retirement Account (IRA), you can pay your premiums for COBRA coverage with those funds. 

To find out how much COBRA coverage would cost you, see your benefit information or contact the person who administers benefits for your employer. 

If your employer filed for bankruptcy, you will not be offered coverage under COBRA. But there may be other, more affordable coverage options.

Medicaid

Medicaid is a type of public health insurance offered through state governments. It was designed to help individuals and families get low-cost or no-cost health coverage when they need it. Current monthly income (after a layoff), not counting economic stimulus payments, is considered to determine if applicants are eligible for coverage. But if you don't qualify for this coverage because of your income, you may be able to get coverage for your children and pregnant women in your family.

Medicaid benefits are not the same for all states. However, they typically include the following:

• help managing chronic illnesses, such as asthma and diabetes;
• common prescription drugs for little or no cost;
• mental health services, such as substance abuse care and therapy;
• Free rides to and from doctorappointments.

If you are an Aetna Medicaid member, you may also have the benefit of doing the following:

• Talk to doctors by phone or by videoconference through the telemedicine service, without the hassle of having to travel and waste time in waiting rooms.
• Earn points that you can redeem for baby supplies like diapers, wipes, and food.
• Get coverage for routine dental and vision care.
• Contact community resources that can help if you need food or shelter.

Medicaid enrollment is open year-round, you can enroll at any time. Contact your state Medicaid office to find out if you qualify for coverage. 

Health Insurance Marketplace

The Health Insurance Marketplace (Healthcare.gov) offers subsidized coverage for people with low incomes. Those who do not qualify for Medicaid coverage are generally eligible to enroll in Medicaid. There are millions of people who don't even have to pay a monthly premium; and those who do have to pay, in 2019 paid an average of $87 per month. ⁴   Remember that the deadline to get new coverage is almost always 60 days after your old insurance coverage stops.

Medicare

If you're 65 or older, you can get government-sponsored health coverage through the Medicare program. Medicare is divided into parts that offer different coverage options. Original Medicare covers hospital stays (Part A) and doctor's fees (Part B). Prescription drug coverage is provided separately through Part D.

You will have to pay a monthly premium for both Part B and Part D coverage. The amount depends on your income. For Part B ⁵ , most beneficiaries pay about $144 per month, and for Part D ⁶ , $30. Coverage can be requested from 3 months before turning 65 years of age, up to 3 months after.

If you haven't already, now is a great time to learn about Medicare deadlines and late enrollment penalties. If you wait 8 months or more after losing your employer coverage to apply for Medicare coverage, you may have to pay a late enrollment penalty for the coverage later. 

You can apply for Original Medicare coverage (Parts A and B) online, by phone ( 1-800-772-1213 ; TTY: 1-800-325-0778) , or in person at a Social Security Administration office from the US If you decide to go in person, make an appointment first. More information is available on the Social Security Administration website.

Another option is to purchase an all-in-one Medicare Advantage (Part C) plan through a private insurance company. This type of plan includes medical and hospitalization coverage. It could also include dental coverage, vision care coverage and prescription drug coverage, gym memberships and other extra benefits.

Medicare can be hard to understand. That's why Aetna offers the free Medicare Transition Services program . Through this program, trained and licensed agents will explain all the health care options available to you and help you avoid penalties. They will also determine if Medicare is the most appropriate option to meet your needs. Call 1-888-675-0447 (TTY: 711) .

You'll find more information about the parts of Medicare and how to choose the right plan here . 

Enroll in a family member's plan

In the realm of health insurance, losing your employer-sponsored coverage is a “qualifying change in marital or family status to change coverage.” That means someone in your family could add you to their health plan outside of the regular enrollment period. 

If you're under 26, your best option might be to enroll in your parents' plan. Those over 26 or married or in a domestic partnership should apply to enroll in their spouse's plan. In any of these cases, you will need to contact the plan holder's Human Resources Department for more information.

Short term plans

You may have heard of Short Term Limited Duration (STLD) insurance. These policies, which cannot be renewed, are designed for people who experience a temporary interruption in their health coverage. For example, for workers who have been dismissed. Short-term plans, which are less expensive than comprehensive coverage plans, are a good option. But it's worth noting that the Kaiser Family Foundation, a nonprofit organization dedicated to health care issues, warns that the coverage of these plans is not enough. ⁷

For example, short-term health plans do not cover services for pre-existing conditions. And unlike the comprehensive plans available through the Health Insurance Marketplace, these plans don't always provide coverage for preventive care, prescription drugs, and mental health care; maternity benefits are not included either.

If you happen to find a short-term health plan, or any other plan, that seems too good to be true, read the fine print! Also beware of imposter websites – they sell coverage for a low price that is not suitable. Websites ending in “.gov” are generally reliable for purchasing health plans.

you have options

As you can see, when they know where to look, laid-off workers have options to purchase some form of coverage. If you're still feeling overwhelmed, consider speaking with a licensed insurance agent. These professionals represent various insurance companies and can find you the policy that has everything you need. Plus, they can help you sign up. This service is free. To find a local insurance agent, consult a lawyer or accountant. You can also get help at the health insurance marketplace.

At Aetna, we're proud to provide our members with special benefits during the COVID-19 outbreak. These include free home delivery of prescription drugs, $0 copay telemedicine visits for mental health counseling services, and one-on-one care manager assistance.

Aetna Resources For Living program mental health services include crisis support lines that can be accessed by anyone during the difficult times of COVID-19. If you're already an Aetna member, call 1-866-370-4842 (TTY: 711). If you don't have Resources for Living, you can still call  1‑833‑327‑AETNA (1‑833‑327‑2386) (TTY: 711).

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zobia Member since July 26, 2022