June 4th, 2020 BY Jennifer Davis
Americans have filed more than 45 million unemployment claims since March, a staggering number that underscores the economic impact of COVID19. The pandemic has forced businesses nationwide to close for months, leaving millions unemployed.
And along with that mass loss of jobs came a mass loss of health insurance for people who relied on a job-based plan.
Were you one of them?
If you lost your job and your health insurance because of it, you likely qualify for a special enrollment period to get Obamacare coverage.
These are full benefits, not short term health insurance (that’s another topic altogether).
Under the Affordable Care Act, the law that governs healthcare in America, you’re entitled to a special enrollment period if you experience a major life change. That includes job loss.
But time’s running out for you to buy health insurance if that’s the case. That’s because this special enrollment period only lasts for 60 days from the date you lost your job.
The following advice primarily applies to people who lost their job on or after April 5, 2020.
If you lost your job before then, you may have other options for getting health insurance. Scroll down to the bottom of this article for more info.
If you’re looking for coverage and you’re inside of that 60-day window, here’s what you need to know.
“Obamacare” coverage is full medical coverage.
As a reminder, “Obamacare” refers to the Affordable Care Act, a law that changed health insurance in the United States by setting rules on coverage. Under the ACA, major medical plans — often called ACA-compliant policies — must cover 10 essential health benefits. These benefits are:
- Preventive care, like wellness visits
- Maternity care before, during and after delivery
- Pediatric care (including dental and vision for kids)
- Emergency care
- Outpatient services
- Prescription drugs
- Mental health care
- Lab work
- Rehabilitative care and equipment
The degree to which a company covers these services is flexible — to some extent. All preventive care (think routine checkups and vaccines) is covered without any cost sharing. That means a routine flu shot won’t cost anything out of pocket, for example. But some types of care, like prescription drugs, might vary from plan to plan.
Still, all major medical policies that meet ACA standards much cover each category of essential health benefit. Obamacare also provides consumer protections, like covering anyone regardless of medical history.
So when we’re talking about a special enrollment period for Obamacare, we’re referring to the healthcare law. And under that law, all ACA-compliant plans provide full, comprehensive medical coverage. Plus, most people qualify for subsidies that lower the cost of premiums for these plans.
Special enrollment periods are for everyone.
The ACA also created an open enrollment period for buying health insurance. If you don’t get coverage through work and need a private health plan, you’ve got one time during the year to sign up. It runs from November 1st through December 15th nationwide, though some states have later deadlines.
If you miss the deadline for the year, you usually have to wait until the next enrollment period. But that’s where a special enrollment period (SEP) comes in.
Major life events, like having a baby or getting married, can trigger a special enrollment period. One of those qualifying life events is losing your job.
Special enrollment periods are available to everyone. As long as you meet the requirements for a qualifying life event, you can apply for health insurance during an SEP. You usually have 60 days from the date of that event to sign up.
Note that this has nothing to do with the current pandemic. The special enrollment period for losing your job is just part of Obamacare already. So if you’re reading this in August and you recently lost your job, go ahead and see if you qualify to use an SEP to get health insurance.
That’s why we said at the beginning that people who lost their jobs on or after April 5, 2020 are rapidly running out of time to take advantage of this special enrollment period. At the time of this post on June 4th, it’s been 60 days since that date.
In fact, if you’re reading this after June 4th, you’ve likely already missed the window. Sorry about that!
But check out the last paragraph of this article for info on how to get covered if that’s the case. You may have options.
Here’s what you need to do to sign up.
Think you qualify for a special enrollment period? Head over to HealthCare.gov. You can check the guidelines and enter your state for more specific guidance. You’ll need to do some legwork if you want to enroll in health insurance.
But getting health insurance is worth the legwork. Unexpected medical bills can eat into your savings, especially when you don’t have regular income coming in. The federal site can also tell you if you qualify for savings on your premiums.
Note that some states have their own health insurance marketplaces. If you live in one of the following states or the District of Columbia, you’ll use a state-based exchange to enroll in health insurance during special enrollment:
- New York
- Rhode Island
These states also set their own deadlines for open enrollment anyway. And sometimes, like during a global pandemic, these exchanges may have a special enrollment available for everyone, not just those who qualify based on life events. If you live in one of these states or D.C., check your state’s marketplace for more info on enrollment.
Can’t afford major medical coverage or missed the deadline for a special enrollment period? Don’t worry. You may still be able to get health insurance.
Don’t qualify for an SEP? Here’s how to get covered anyway.
If you’re reading this and you missed the window for signing up for a special enrollment period — and it’s not yet open enrollment, which happens in the fall — then you may still be able to get health insurance.
First, try Medicaid. Most states expanded Medicaid coverage thanks to guidelines under the Affordable Care Act. If you’ve never qualified before but live in an expansion state, check with your state’s Medicaid program. Even if you don’t live in a state that expanded Medicaid, it doesn’t hurt to check if you qualify. This joint federal-state program is designed to help people with low incomes get health insurance.
And if you have kids, look into CHIP in your state. The Children’s Health Insurance Program, called by different names in each state, provides health insurance for children whose parents don’t qualify for Medicaid.
You could enroll in your former job’s COBRA coverage, but these plans are typically too expensive for most families. That’s because you’re paying the full cost of your job-based insurance without the benefit of employer contributions.
Outside of open enrollment, a special enrollment period, a federal program or COBRA, you won’t find major medical insurance readily available. In that case, we recommend short term health insurance.
Short term health insurance can bridge the gap between coverage.
Consider short term health insurance as a temporary safety net — because that’s what it is. Short term plans give you basic emergency coverage for things like unexpected injuries and illnesses. It’s not the same as major medical coverage, and it won’t cover the same level of benefits. These plans don’t have to adhere to the rules of the ACA. And for people with existing health problems, short term plans aren’t great.
But if you’re healthy, you’ve missed the enrollment periods for major medical or you just need something to bridge a gap between comprehensive benefits, short term plans might work for you. Need more info? Check our article on the myths of short term health insurance.
Buying health insurance when you’re out of a job — even temporarily — might seem like a waste of money. But having a plan in place in case of medical mishaps can give you peace of mind when things seem otherwise uncertain.
The last thing you want to worry about when you’re unemployed is how to pay for an unexpected medical bill. You have options. Make sure you explore all of them.