Getting laid off or fired from a job doesn’t just mean a lost paycheck—for many Americans, it also means lost health insurance. As of 2018, nearly half of the U.S. population received employer-sponsored health insurance, according to a survey conducted by the Kaiser Family Foundation. It’s a problem that became all-the-more salient during the novel coronavirus pandemic (COVID-19) when record numbers of people in the U.S. lost their jobs and their coverage at the same time their risk of getting sick skyrocketed.
And without health insurance coverage, you may be wondering how you’re going to pay for important medical expenses like doctor visits, prescription drugs, and emergency care. But there are options—employer-sponsored plans aren’t the only path to health coverage.
RELATED: How to get health insurance
|Lost health insurance?
Compare your options
|COBRA or federal Marketplace plans||Provides continuous coverage after job loss||These plans are often more expensive than employer’s health insurance plans||Learn more about COBRA|
|Medicaid or CHIP||Cheapest health insurance options||You must meet income eligibility requirements||Learn more about Medicaid|
|Short-term or gap insurance||You can enroll at any time||Not as comprehensive as long-term health insurance||Learn more about short-term health insurance|
|SingleCare||Coupons are 100% free, reusable on every refill, and no insurance is required||SingleCare is not a form of health insurance||Learn more about SingleCare|
I lost my job. What do I do about health insurance?
If you’ve recently lost or left your job, you may be eligible to extend your current coverage under COBRA (The Consolidated Omnibus Budget Reconciliation Act). This legislation stipulates that—if certain criteria are met—an employer must extend your group health plan for up to 18 months following your change in employment. In some limited circumstances, coverage may last up to three years.
There are three main criteria that must be met for a person to qualify for COBRA health insurance, according to the U.S. Department of Labor, Employee Benefits Security Administration:
- Your group health plan must be covered by COBRA
- A qualifying event must occur (termination for any reason other than misconduct, leaving a position, or reduction in hours)
- You must be a qualified beneficiary for that event
Spouses and dependent children may also qualify for COBRA, though the list of criteria differs. (You can see the full list here.)
If you qualify for extended coverage under COBRA, you will be given a specific time period (typically 60 days) during which you can elect coverage, retroactive to the date your coverage otherwise would have ended. If you fail to elect COBRA coverage during this time, you will not be able to do so later.
Coverage under COBRA is often more expensive than insurance through your job because your employer was likely helping pay for your monthly premiums. They are not required to do so under COBRA. Coverage length also varies—18 months is the minimum, though it could extend to as long as 36 months, depending on qualifying events.
Information about how to apply for COBRA should be included with the plan information you received when your coverage began. You’ll also likely receive correspondence from your insurance plan or employer about the next steps for COBRA once your employment status changes.
If you decide to not elect COBRA coverage or it is not available to you because you do not meet all of the criteria, you may want to consider the Health Insurance Marketplace (or simply, the Marketplace), where you can compare rates for private health insurance plans. Once again, you’ll want to be aware of certain time restrictions when investigating your options. A Special Enrollment Period is typically extended to someone who has recently left or lost their job, but you must select a plan within 60 days before or 60 days after losing your coverage through work. If not, you will likely need to wait until the open enrollment period to get coverage. Also note that open enrollment periods may vary, depending on whether your state has its own exchange or relies on the Federal exchange. You can find more information at healthcare.gov.
I need health insurance, but I have no income
If you are unable to afford health insurance, check to see if you are eligible for coverage under a family member’s plan. For those under the age of 26, you may be able to join a parents’ plan—depending on their plan—even if you do not live with them or are not financially dependent on them. Conversely, if you are married or in a long-term partnership, you may be able to join your spouse or partner’s employer-sponsored plan. A marriage counts as a qualifying life event, which means you can be added to your spouse’s plan within 30 days (or longer) of being married. If you don’t meet this deadline, you will likely need to wait until the next open enrollment period to join.
If a family member’s plan isn’t an option, you may qualify for coverage under Medicaid or the Children’s Health Insurance Program (CHIP), two federal and state health insurance programs that assist low-income Americans with medical costs (either by providing insurance directly or through a private plan). As of February 2020, 63.8 million Americans were covered under Medicaid. The costs and coverage differ from state to state (some states, for instance, provide coverage for any adult whose income falls below a certain threshold each month), so you’ll need to research your state’s requirements. There are two ways to apply for Medicaid if you don’t automatically qualify:
- Through the Health Insurance Marketplace: If after filling out the application, it appears you or someone in your household may qualify for Medicaid, the Marketplace will forward your information to the state agency that administers Medicaid. During this process, you may also qualify for savings (such as an Affordable Care Act subsidy) on a private plan based on your income, which may actually make a private plan within reach financially.
- Directly through your state Medicaid agency: Find out how to contact yours here.
RELATED: Medicaid changes 2020
How to get health insurance back
If you’re in immediate need of coverage but the open enrollment period is still months away, you may want to consider a short-term health insurance plan as a stopgap. Original guidelines passed in 2016 stipulated that short-term insurance could only last three months. However, new rules under the Trump administration extend that time period to 364 days, with the possibility of a further extension of up to 36 months.
To be clear, short-term insurance does not offer the same comprehensive coverage as a group health plan or a qualified plan under the ACA. For instance, short-term plans do not have to cover prescription costs, maternity costs, or people with pre-existing conditions. The upside is that you do not need to wait for an open enrollment period, and coverage typically begins within days of your application being accepted.
Another source of supplemental insurance is gap insurance (AKA “insurance for your insurance”). While it’s not intended to be used as a person’s only coverage, some people do use it that way while uninsured. This type of policy usually works in conjunction with your primary health insurance (a group health plan or ACA plan) to provide additional coverage. For instance, if your employer-sponsored plan doesn’t cover dental work, you may be able to find gap insurance that does.
Gap insurance coverage is very specific and may take effect only in certain instances, like a heart attack or stroke. Popular insurance companies include AIG, Aetna, and Aflac, and premiums average around $30-$40 a month.
Ideally, short-term insurance (and gap insurance as your only means of coverage) are to be used until you can qualify for long-term coverage during an open enrollment period. While open enrollment for 2020 has passed, 2021 dates are coming up: Mark your calendar for Nov. 1, 2020 through Dec. 15, 2020. While most states adhere to those dates, not all do, so you’ll want to check dates for the state you live in. Additionally, California, Colorado, and Washington, DC, have extended their open enrollment windows permanently. Medicaid enrollment is also open year-round.
Whether you’re uninsured or underinsured, SingleCare can help you save money on your prescription medications. SingleCare is a free prescription savings service that can help reduce your bill at thousands of pharmacies around the U.S. You can use our card without insurance to help you save on the cash price of the medication.
For instance, in 2019, the average cash price for Oseltamivir phosphate (an antiviral known by its brand name Tamiflu) was $136.30. With the SingleCare card, the average price dropped to $52.51. Download your free SingleCare card here.