Have you or a family member lost health insurance coverage?
With so many people experiencing job loss right now, that often means a loss of health insurance coverage, too. If you or a family member are suddenly without health insurance, you have a number of coverage options.
Qualifying Event
First, it’s important to understand that the loss of coverage as a result of a reduction in hours or loss of employment is considered a qualifying event. A qualifying event is a major life change that triggers a special enrollment period, allowing you to make changes outside of the annual Open Enrollment period. The time frame for the special enrollment period for a qualifying event is typically only 30 days, but it can be longer in some circumstances.
COBRA
COBRA is a federal law that allows you to temporarily continue your employer-sponsored health coverage by paying the full cost of the premium plus a small administrative fee. If you qualify for COBRA, you can expect to receive a notice from your plan’s COBRA administrator giving you 60 days to elect COBRA continuation.
Arc WC-sponsored coverage
When you or an eligible family member experience a qualifying event, you have 30 days to make coverage changes which will take effect the first of the month following the loss of coverage or other qualifying event. I will need to see confirmation of the loss of coverage – that could be a letter from a former employer or a COBRA notice, anything that documents the loss of coverage. Please see the attached benefit summary for the cost of coverage. You can add coverage for yourself or your family member online at KTBSonline.com. Login (if it’s your first time, you’ll need to register using your SSN) and select Add/Change Benefits. Then select your qualifying event and the site will walk you through it. If you run into any difficulties, just call or email me and I will gladly answer questions and help you with your coverage change.
Marketplace
Loss of coverage is also a qualifying event for getting coverage through the health insurance marketplace, so you might want to look at plans through the exchange at HealthCare.gov. If you live in Maryland, use Maryland Health Connection (marylandhealthconnection.gov). In addition, Medicaid, Medicare, and CHIP/SHIP programs may provide affordable options for you, if you qualify.
If you are a resident of Pennsylvania and want Marketplace enrollment assistance, contact the Pennsylvania Association of Community Health Centers (PACHC) Navigator Hub at 1-866-944-CARE (2273).
If you are a resident of West Virginia and want Marketplace enrollment assistance, call (304) 414-8480 or visit wvinsurance.gov/HealthPolicy.
If you prefer to sign up for a Marketplace plan without assistance, you can visit HealthCare.gov or call 800-318-2596.
What if you just don’t have healthcare coverage and now you want it?
The Maryland Health Connection has opened a special Coronavirus Emergency Special Enrollment period through June 15 for uninsured Maryland residents who want to enroll. You don’t need a qualifying event to enroll during this time.
Pennsylvania and West Virginia residents use HealthCare.gov, which is not offering a special enrollment period because of the Coronavirus pandemic. You would need a qualifying event to enroll in a Marketplace plan if you reside in either Pennsylvania or West Virginia.
 |
See if you qualify for a Special Enrollment Period. 2020 Open Enrollment is over, but you may still be able to enroll in 2020 health insurance through a Special Enrollment Period.
www.healthcare.gov
|
As a reminder, federal law and regulations provide protections against pre-existing condition exclusions in health insurance coverage. If you are eligible, health plans must permit you to enroll regardless of health status, age, gender, or other factors that might predict the use of health services. Marketplace plans can’t terminate coverage due to a change in health status, including diagnosis or treatment of COVID-19.
Please note that this situation is evolving rapidly as is the response from employers, insurance providers, and local, state, and federal governments.
If you have questions or need help, please contact me.
My best wishes to you and your loved ones,