What if I Lose Health Insurance Due to Coronavirus?
Unfortunately, this is a very popular question right now.
The good news is that we have options as a result of losing employer health insurance.
There may even be options if you didn't have health insurance but want to buy it now.
We'll look at the best way to compare the options and how the whole income piece figures in (since it's in flux after job loss).
These are the areas well cover:
- What options do I have if I lose health insurance due to coronavirus
- When can new coverage start after loss of health coverage
- How do I calculate income after job loss
- What's the timetable to enroll for health insurance after job loss
- What effective date can I get
- WIll there be waiting periods on new plan after job loss
- Strategies for choosing health plans after job loss due to coronavirus
- How to quote and apply for new coverage after job loss due to coronavirus
So...let's check one
What options do I have if I lose health insurance due to coronavirus
Okay...with millions of potential layoffs (hopefully short-term), many people are scrambling on the health insurance side.
We have some good news there in a sea of bad right now.
Loss of employer coverage makes you and your dependents, eligible for coverage outside open enrollment.
We need to enroll within 60 days of the last date of group coverage but we'll cover important pieces below in the timetable section.
Depending on income, we may be offered tax credits to reduce the cost or medi-cal below a certain income range.
That piece is trickier so we'll break it out separately below.
The plans available are the ACA (Affordable Care Act) plans with bronze, silver, gold, and platinum plans.
There may be split policies depending on income where adults are offered tax credits and childen below 18 are offered medi-cal. We can help navigate that whole process to get ideal plan suite for you and yours.
We're certified Covered Ca agents and there's no cost to our services!
We have personally enrolled 1000's of Covered Ca apps.
One note...the tax credit is only available on-exchange and the networks, pricing, and benefits are identical on or off-exchange.
For this reason, we enroll 99% of people on-exchange.
The only time there's a difference is if you don't qualify for a tax credit and want the silver plan.
Look….if you're not qualifying for a tax credit and just lost your job, the bronze plan may be a better fit anyway (depending on age which drives cost).
We can help with your specific situation.
You can quote and access the simplified application here:
How quickly can we get health insurance after losing our job?
When can new coverage start after loss of health coverage
New coverage can start the 1st of the month AFTER we enroll.
Medi-cal can actually go back to the 1st of the month we enroll in.
For this reason, we really want to enroll prior to when your group plan ends.
For example, if you're losing group health insurance March 31st, we want to enroll during march to get a 4/1 eff date.
Otherwise, it will get pushed out to 5/1.
Most people will have a Cobra option (although likely very expensive) which typically has a 60 day window to elect it RETROACTIVELY back to the last date of group coverage.
This works like an insurance policy (pardon the pun) in case something happens if we've missed the enrollment date.
One note...providers will want to see an ID card and it may not show active until the Cobra payment is paid so be careful.
The best option is to enroll prior to the 1st following when your group plan ends.
Let's look at the trickier part.
How do I calculate income after job loss
This is obviously in flux. Here's what we're trying to do.
We want to estimate our Adjusted gross income on April 2021's 1040 tax form.
Great. That's not easy right now.
- If you're on payroll, this is usually gross income
- For self-employed people, this is generally net income (after business expenses, health insurance costs, ½ self-employment tax, etc)
The AGI on the 1040 is the easiest approach but some people will have to add back in the following:
- Foreign income
- Tax-free interest
- Social Security
Unemployment would be included and for many people in this situation, that's going to be a key source that keeps us above the medi-cal range.
If you're drawing down funds (say from a 401K), we would include it if it's a taxable event.
Again, this gets tough and we're happy to help walk through your personal situation (there's no cost for our assistance).
Contact us at 800-320-6269 or at help@calhealth.net
What's the timetable to enroll for health insurance after job loss
Here are the key timing issues to keep in mind:
- We need to enroll prior to the 1st of the month we want the plan to start (except medi-cal)
- We need to enroll within 60 days from last date of group coverage
Those are the two key steps.
If you've missed either, contact us and we can go through any special options (which undoubtedly come our way after coronavirus).
Effective dates after loss of coverage are important especially in today's world.
What effective date can I get
We can only get the 1st of a given month.
It will be the 1st of month following our enrollment.
For example:
- If we enroll on March 15th, we'll get April 1st. Any day during March would result in 4/1
- If we enroll on April 1st, we would get May 1st
Medi-cal can go backwards to the first day of the month in which you enroll.
For this reason, try to apply via link below BEFORE the 1st of the month.
We don't want lapses of coverage in today's world.
What about pre-existing issues?
Will there be waiting periods on new plan after job loss
There is no waiting period for benefits or for pre-existing conditions when we enroll in ACA health plans.
If your plan starts April 1st, you are eligible for benefits April 1st according to your plan choice.
One note...medi-cal can take a while to process. We generally don't see an ID card for 20-30 days after enrollment.
Hold on to your Covered Ca enrollment confirmation (usually comes about 5 days after enrollment) for what's called "emergency medi-cal" to get services before you're officially in the system.
Let's now look at how to view all this.
Strategies for choosing health plans after job loss due to coronavirus
We need to take into account some key items when choosing a plan following job loss:
- Monthly cost since cash flow may be tough (benefit level - bronze, silver, gold, and platinum)
- Carriers and networks
- Family health needs
First cost.
We really want to dial in the income piece to make sure we get the most tax credit available.
This is usually the biggest mistake people make (getting too little or too much and having to pay it back).
Call or email us to go through this as it's complicated (a bit like taxes).
Two quick points:
- Household is everyone that files together on a 1040 tax form the FOLLOWING year regardless of enrollment
- Try to estimate adjusted gross income with unemployment included
The unemployment amount is designed to be just above the medi-cal limit so you may want to use that currently monthly amount to get the most help right now if cash flow is really hit hard.
Again, we can strategize on this to make sure you get the best situation.
You can get very rich versions of the Silver plan depending on income.
If you're getting the Silver 87 or 94, there's no reason to go higher.
They're very rich.
That would leave the Silver (for richer benefits) or Bronze if you just want catastrophic coverage.
Even within a given metallic level (bronze for example), there can be price differences between carriers and networks (HMO versus PPO as an example).
The benefits are the same (standardized) from carrier to carrier so it's really a question of the size of networks and the type (HMO, PPO, EPO).
Here's the deal...yes, the PPO sounds great but we need to think a few months out (as coronavirus is estimated to last 3 months at best).
We need to be able to afford this option a few months out so keep that in mind.
The real important piece is that we have coverage in case of hospitalization with coronavirus.
The medication piece may be a factor (Silver and above) if outpatient.
Check out hydroxychloroquine and coronavirus or antivirals for coronavirus to understand why this is important.
We then need to compare this with the increased flexibility a PPO will offer over an HMO.
We don't yet know how that matters in terms of coronavirus treatment but the serious conditions (ICU, etc) would likely have the same treatment because of the severity.
We can discuss this with you at help@calhealth.net or 800-320-6269
How to quote and apply for new coverage after job loss due to coronavirus
This is easy part.
You can access the quote after job loss here:
A few notes.
Make sure to put in the total # of household members even if not enrolling. This can affect your tax credit.
If something doesn't look right, send over your zip code, dates of birth, and best estimate for this year's income to help@calhealth.net noting who is enrolling and we'll run the quote for you.
If our income is below a certain level, the quote engine may show the full rates for the kids instead of medi-cal.
We can still get the standard plans for the kids but without a tax credit if you don't want medi-cal for them.
There's a special way to do this though (we have to create a separate account) so let us know if that's what you want.
If you have questions, definitely check in with us.
As for enrollment, we've made it very easy.
The simplied online application is available here and generally takes 5-10 minutes.
We process it on this side generally within 24 hours and it's very common that we come across issues or opportunities which we'll reach out to you about when enrolling.
It's a second pair of very trained and experienced eyes for a complicated process.
There's no cost to you as certified Covered Ca agents.
We'll get through this mess but in meantime, make sure to have at least catastrophic health coverage.
If you're not seeing a tax credit or something looks confusing, reach out to us. We're happy to help.
We're happy to walk through how this works.
Call us at 800-320-6269 or email us with any questions.
As Certified Covered Ca agents and licensed agents, there's zero cost for our assistance.
How can we help?
You can run your Covered California health quote here to view rates and plans...Free.
Again, there is absolutely no cost to you for our services. Call 800-320-6269 Today!