What if I lose coverage at work?

December 21, 2013

If you lose your health coverage at your job, you have 2 main options for health insurance: 1) Enroll in an individual or family plan (through AHIPE - that's us!) or 2) Continuing your group coverage through COBRA.

Get the Facts:

 

If you lose your job and/or your job-issued health insurance, you may want to buy an individual or family plan instead. 

If you qualify for a tax subsidy based on your family size and household income, you can lower your healthcare costs on private plans. A tax subsidy is the amount of money the government will pay each month to your private health insurance company to make your plan affordable for you based on your household income and family size.  


If you do not qualify or don't want to use a subsidy, you can still enroll in a private plan offered through the private exchange instead. AHIPE offer both public (governement subsidy) and private plans (no subsidy). 

 

Or, you may have the option of continuing your coverage for a period of time through COBRA. COBRA is generally for employers with 20 or more employees on the plan, so if your employer is too small for COBRA, you might have a different continuation option in your state. 

Let's summarize: 

1) Get an individual or family plan: If you lose your health insurance through your job for any reason, you can enroll in a private plan through the exchange. This is true even if you leave your job outside the Open Enrollment period (first year is October 1, 2013 to March 31, 2014). By using the exchange, you could qualify for lower costs based on your household income to keep the plans affordable for you. You can't be turned away or charged more because of pre-existing conditions, how often you use your plan, gender, or profession. Pre-existing conditions and pregnancy are always covered. All plans must include Essential Health Benefits (things like hospitalizations  ER, Rx, etc) with no yearly or lifetime limits so you can never run out of insurance for core care.   

2) Use a continuation option for smaller businesses (varies by state): COBRA might not be available to you if your employer is too small to qualify for COBRA (generally speaking, "too small" means employers with less than 20 employees on the health plan for more than half of the previous plan year). If COBRA isn't an option, there might be a different continuation option for small employers in your state. COBRA is a federal law that may let you pay to keep you and your family on your employee health insurance for a limited time (usually 18 months) after your employment ends or you lose coverage through your job.

If you decide on COBRA continuation coverage, you won't be able to get any of the lower costs on premiums or out-of-pocket expenses when you use your plan. You can only qualify for reduced costs through individual or family private plans in the exchange. 

 

Individual Requirement to have health insurance:

 

If you do not have coverage that is considered minimum essential coverage (this could be a private plan, coverage through your job, or a government-sponsored health plan like Medicaid, Medicare, CHIP, Tri-Care, etc.) starting in January 2014, you have to pay a penalty, if you don't qualify for an exception. You will also have to pay all of the costs for your health care and will have no financial protection if you get sick. 

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