As of May 2020, the South Carolina unemployment rate is 12.5% according to the U.S. Bureau of Labor and Statistics. “We need to find health insurance. Where do we start?” This question will face thousands of South Carolinians who have lost their jobs along with their employer-provided health coverage as a result of the COVID-19 pandemic.
Some reports suggest that some individuals may forego enrolling in insurance at all, and the health and financial impact of going without could have long-lasting consequences. And yes, choosing the right health coverage may seem daunting – since many Americans have never shopped for coverage before or worry that they cannot get affordable health insurance.
People affected by the economic impact of COVID-19 should know that there is a wide range of coverage options available to meet their unique care needs and financial situations, some of which are free or subsidized. These may include Medicaid, Medicare, the Affordable Care Act (ACA) exchange plans and other individual coverage.
Questions to Ask
To find the right coverage, it’s important for people to know what is available, what to ask, and what information they need to enroll. To narrow your options, be prepared to discuss:
• When does your employer-sponsored coverage end? – Depending on your plan, you may have a few weeks or more to make coverage decisions.
• Does your company offer COBRA (Consolidated Omnibus Budget Reconciliation Act)? – Under COBRA, individuals maintain their current plan benefits while paying the total cost of the insurance including their premiums and the amount contributed by their employers. Recent federal regulation has extended some of the COBRA deadlines.
• Does your spouse’s/domestic partner’s employer provide coverage? – Under certain circumstances, a “special enrollment” allowance may be offered.
• What benefits does your family need or want?
• What can your family afford? – Think about what portion of your monthly budget can be used for health coverage or other insurance. Your family may be eligible for additional options based on your specific financial situation.
Health Coverage Options
If COBRA and spousal coverage are not available or too cost-prohibitive, here are just a few options to consider:
• Medicaid/Medicare – While Medicare coverage is primarily available to individuals over age 65, Medicaid eligibility is primarily based on income, disability, family size and other circumstances that can factor into eligibility.
• Individual exchange plans – These ACA plans are available through federal or state enrollment sites. Based on families’ income, they may be eligible for plan subsidies making one of these plans more affordable. Recent job loss often would be a “qualifying life event” allowing a Special Enrollment Period into an ACA plan outside of the Open Enrollment period.
• Short-term plans – Short-term limited-duration insurance coverage provides temporary coverage to bridge the gap between longer-term insurance coverage. These plans have a fixed duration of a few months to even several years and generally will offer less robust coverage than ACA plans.
Health Care Coverage Guidance and Enrollment Support
People can find support through health care marketplaces, insurance brokers and other licensed insurance agents to help determine what plan is best for them.
For example, GetCovered is a free service offered through HealthMarkets, one of the nation’s largest health insurance agencies, that provides guidance for people who need health coverage. Licensed insurance agents work with individuals to help determine eligibility for health coverage through Medicare/Medicaid options or to find commercial health plans that best meet their individual needs – and help them enroll in these plans, where they are able.
Health coverage decisions can be made simpler – and there are resources to help. Regardless if you choose to do your own research and enrollment or engage outside services, determining what you and your family need and can afford will help you find good health coverage that ensures you have access to care now.
Source: Mark Smith
President, HealthMarkets Insurance Agency