For many, the prospect of being uninsured amid a pandemic like the coronavirus adds yet another layer of anxiety to an already stressful time. If you fall ill with the coronavirus, how will you pay for healthcare?
Nearly half (48%) of U.S. adults say they are “not very confident” (23%) or “not confident at all” (25%) that they could deal with the costs if they were to fall ill with the coronavirus, according to a nationwide survey by healthcareinsider.com. More than half (59%) of uninsured survey respondents say they are not at all financially prepared to deal with the cost if they were to become ill with the coronavirus.
These concerns are certain to grow.
As many as 47 million Americans could lose their jobs in the second quarter of 2020 as a result of the coronavirus outbreak, according to estimates by the Federal Reserve Bank of St. Louis. One recent study estimated up to 35 million workers could lose their health insurance as a result.
Fortunately, there are ways to get healthcare coverage right now for the 30.1 million uninsured Americans under age 65 and one of the 16 million (and counting) who lost their job between March and early April or will be one of the potentially millions more laid off in the months to come.
1. COBRA Continuation Coverage
This first option applies only to workers who lose employer-sponsored health insurance due to unemployment or a reduction in hours. COBRA allows you to extend your job-based health plan for 18 to 36 months, depending on the circumstances.
This option allows you to maintain your existing coverage. That means you won’t have to start over with a new plan deductible and you retain access to the network providers you already use, for example. The Families First Act applies to group coverage, which means your plan should cover no-cost coronavirus testing. Any other coronavirus-related treatment will be subject to your policy’s benefits and cost-sharing requirements.
In ordinary times, the cost of COBRA is often a big drawback. Unless Congress moves to provide the recently uninsured subsidies to buy COBRA coverage, you typically pay the full monthly premium amount (i.e., your share plus the share your employer paid) plus a 2% administration fee. Obviously, COBRA is expensive, especially when faced with a reduction in income.
2. ACA Special Enrollment + Emergency Special Enrollment
The annual ACA open enrollment period for individual major medical plans ended months ago; however, it’s possible you can still get this coverage.
Several states have reopened their health insurance exchanges as a result of the coronavirus outbreak. In those places, anyone who needs health insurance can buy it right now
Participating states include the following, as of April 15, 2020:
- California — March 20 through June 30, 2020.
- Colorado — March 20 through April 30, 2020.
- District of Columbia — Through June 15, 2020.
- Maryland — March 16 through June 15, 2020.
- Massachusetts — March 11 through May 25, 2020.
- Nevada — March 17 through May 15, 2020.
- New York — March 16 through April 15, 2020.
- Rhode Island — March 14 through April 30, 2020.
- Vermont — Through May 15, 2020.
- Washington — Through May 8, 2020.
The Trump administration has declined to offer an emergency special enrollment period for states that use the federal exchange. If you live in a state without emergency enrollment, you could be eligible for ACA special enrollment if you have a qualifying life event such as getting married, moving to a new ZIP code, or having a baby.
Job loss is another qualifying life event that triggers a special enrollment period. Even if you quit or get fired, you have 60 days to enroll in coverage through federal and state-based exchanges — COVID-19 or not.
During standard and emergency special enrollment periods you can apply for income-based premium tax credits and cost-sharing reductions to help reduce your monthly premium and out-of-pocket costs (e.g., deductible, coinsurance).
3. Medicaid
You may qualify for no-cost or low-cost coverage through Medicaid, which offers healthcare benefits subject to the Affordable Care Act. Medicaid is available year-round. You’ll need to visit your state’s health insurance exchange to apply. Many states have loosened requirements.
4. Short-Term Medical Insurance
What if you don’t qualify for Medicaid or special enrollment with a premium tax credit? You may want to consider short-term health insurance, coverage designed to help you pay for healthcare while you are in-between group or individual major medical plans.
Due to their temporary nature, short-term plans are designed to have economical monthly premiums and benefits for medical expenses related to injury and unexpected illnesses. However, pre-existing conditions are not usually covered.
While not subject to the Families First Coronavirus Response Act or the ACA, short-term plans offered by companies like Pivot Health cover the cost of testing and medical services related to treating COVID-19. For example, short-term plans will typically include benefits for doctor office and telemedicine visits. Short-term plans do not include all of the ACA’s essential health benefits.
Short-term health insurance is available year-round, but it is not sold in every state. Depending on where you live, policies can last as few as 30 days and up to 364 days. There are no open or special enrollment periods.
We are living in unprecedented times, but one aspect you can control is picking the right type of health insurance coverage that suits your needs.
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