More than 1 million Texans have lost their jobs in the fallout from the coronavirus pandemic, and with that comes the loss of many employer-sponsored insurance plans.
Early estimates from Health Management Associates, a health care research firm, show that up to 3 million Texans could be out of health insurance by the end of the pandemic due to company shutdowns and layoffs.
“Many who were let go have also lost their employer-paid health coverage at a time when they need it most,” said John Ford, the association’s spokesman.
Here are your options for health insurance if you’ve lost your job.
Where to start
First, check for any communications from your employer about COBRA or state continuation eligibility. You can begin looking at plans yourself if you elect not to take federal or state-continued coverage, or don’t have that as an option.
Registered health insurance agents (you can check if they have a Texas license on the Texas Department of Insurance website) and TDI representatives can help individuals navigate plans. The state health coverage line is 800-252-3439.
Those who have lost their employer-sponsored insurance can apply for continuation of health insurance under the Consolidated Omnibus Budget Reconciliation Act, or COBRA. It’s applicable to plans administered by employers with 20 or more employees, according to the U.S. Department of Labor.
Employers must notify workers of continuation eligibility within 14 days of termination. Workers have to sign up for COBRA coverage within 60 days of job loss. And if you waive the coverage within 60 days but decide during that same period you’d like to hop aboard, you can do so.
COBRA allows employees and their beneficiaries to continue on the plans they had before for 18 months. If you’re sticking to a certain doctor or provider for any given reason, and the plan was worth the cost, it’s worth staying on with COBRA.
You should also consider COBRA if you’ve already met your deductible for the year, said Tonya Booth, president of the Texas Association of Health Underwriters, which represents health insurance agents in the state.
However, people enrolling in COBRA likely will face steeper charges. Employers may elect to stop paying the coverage, sticking the former employee with the full bill.
Texas offers nine months of health insurance continuation for those not eligible for COBRA. The nine month enrollment period of state continuation can be especially beneficial for those planning to job hunt, Booth said.
“If you’re getting a plan from May to the end of the year, you’ll know whether you’ll get back to work,” Booth said. “If not, you look at that point in time for open enrollment for a true exchange plan.”
Before opting for other coverage, double check if your employer has allowed furloughed workers to keep their benefits. Some insurers, such as Humana, are temporarily dropping conditions that would prevent furloughed workers from getting their health benefits.
“In response to the COVID-19 pandemic, we have relaxed our requirement for employees to be actively at work in order to be eligible for coverage, said Martin Hill, a Humana spokesperson.
People who have exhausted the 18-month COBRA coverage can receive an additional six months of continuation. Under state continuation, the planholder must pay the full premium.
In a few cases, the Affordable Care Act health exchange for private health insurance plans is open outside of the open enrollment period to those who have lost coverage, said Ben Gonzalez, a spokesman for the Texas Department of Insurance.
“If you were getting your insurance through work, then you lost it, that’s a qualifying event that will allow you to go to healthcare.gov and shop for a plan,” Gonzalez said.
Dozens of policies are still available on the marketplace.
For people who plan to shop the marketplace, it’s important to consider the costs of a plan that would also cover the care of any beneficiaries, like children or grandparents. Consult with an insurance agent or a Texas Department of Insurance representative about which plans are right for the family.
Medicaid or CHIP
If financial times are really dire, the state’s Medicaid, Medicare and Children’s Health Insurance Program (CHIP) programs are enrolling people.
Those who are pregnant, parent of a dependent child under age 19, blind, have a disability or a family member who is disabled or are 65 and older can enroll in Medicaid. CHIP is available for Texas children 18 or younger.
A family of four must make $50,985 or less a year to qualify for Medicaid in Texas — a condition that could be helpful for those who have lost the job that provides benefits, but still sees some income.
“They shouldn’t be ignored because we think everybody does better with some kind of health coverage,” Gonzalez said.
Short-term health plans
If you don’t have any other health insurance options, short-term health plans could be useful as a stopgap while searching for work. This is an option worth considering if you’re healthy and don’t have pre-existing conditions.
“Those plans are great if you’re between jobs, coming off your parents’ plan or in the waiting period with a new employer,” Booth said.
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But people with health issues requiring more medical care may not be covered by short-term health plans.
Researchers said that the plans are more likely to leave patients with higher out-of-pocket costs. Some short-term plans are also not regulated by the state, meaning that they’re not subject to guidance issued by the Texas Department of Insurance. For instance, while a state-regulated employer-sponsored plan would have to cover coronavirus-related illnesses, short-term health plans have no obligation to do the same.
“You have to be very careful about what you’re purchasing and know who you’re purchasing from,” Gonzalez said.