What Are Your Options if You Lose Health Insurance Coverage?
Losing health insurance coverage can be stressful. But fear not; you have several options if you've recently lost your coverage.
Common Reasons for Loss of Coverage
Many Americans have job-based health insurance. That means leaving a job will end your health insurance coverage. Life changes than can cause a loss of coverage include:
- Losing job-based health coverage
- Losing a family member’s job-based coverage plan
- Changes in your household, such as getting divorced or having a death in the family
- Changes in residence, such as moving to a new ZIP code where your plan doesn’t offer coverage
What Are My Options After Losing Health Insurance?
So what happens if you lose health insurance? Whether you lose coverage due to a change in employment status or some other life change, you have a few options.
Option 1: Health Insurance Plan through the Marketplace
One of your best options is to buy an affordable health plan through the Health Insurance Marketplace®. When you lose your job—whether you left your job or were laid off—you’ll qualify for a Special Enrollment Period. If you lost your health insurance in the last 60 days or expect to lose your coverage in the next 60 days, you can enroll in a Marketplace plan.
Option 2: COBRA Coverage
In some cases, you can stay on your employee health insurance plan even if you lose your job. The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives you and your family the option to use your employer’s group health benefits while you transition to a new job or experience other life changes. You can stay on the plan for up to 18 months, but you will pay the full premium costs as well as an administrative fee.
Option 3: Subsidized Coverage
If you’re deciding between a Marketplace plan and COBRA, it’s important to know that you may qualify for subsidized coverage. When you provide details about your income during the Marketplace application, you’ll find out if you qualify for any cost savings programs. For example, the premium tax credit can lower your monthly premium. And cost-sharing reductions can help pay your out-of-pocket costs such as deductibles, copayments and coinsurance. These extra savings are based on your income and family size.
If you lose coverage but will soon be eligible for Medicare, subsidized coverage can help you retire before you’re eligible for Medicare at 65. For anyone who chooses to leave their job or gets laid off a few months or years before turning 65, affordable Marketplace coverage makes healthcare more accessible.
Option 4: Medicaid Coverage
Depending on your income, you may qualify for Medicaid coverage. Each state oversees a Medicaid program designed to help adults and families with low incomes get the healthcare they need. Medicaid offers low-cost or free health coverage. You can apply for Medicaid at any time and you don’t have to wait for an Open Enrollment Period. But keep in mind that Medicaid eligibility is based on your income for the entire year, so if your income was high at the beginning of the year, you may not qualify for Medicaid.
Option 5: CHIP Coverage
The Children’s Health Insurance Program (CHIP) provides comprehensive healthcare coverage for pregnant women, children and families with low incomes. CHIP offers health insurance coverage for millions of Americans. Just like Medicaid, you can apply for CHIP at any time. Fill out an application through the Marketplace or contact your state CHIP program directly.
Coverage Is Available
If you’re losing health insurance coverage, know that you have options. Getting your own healthcare plan isn’t as complicated or expensive as it might seem. Need help? Contact CareFirst to discover the best coverage options for you and your family.