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Week of 3.20.09

Tips for the Unemployed and Uninsured

Families USA, a nonprofit advocacy group for affordable health care, has produced a report: "Getting Covered: Finding Health Insurance When You Lose Your Job" (pdf). The report highlights options for getting health insurance if you are one of the millions of Americans who have recently lost their jobs.

The good news is there are more options for healthcare coverage than you may have thought.

money and stethoscope As a result of the American Recovery and Reinvestment Act that was signed into law last month, there are now a variety of health insurance options for people who have lost their jobs.

Below is a summary of the options. See the full report (pdf) for more details.

Option 1: Coverage through a spouse's or domestic partner's employer

As always, the best option if you recently lost your insurance is to seek coverage under a spouse or domestic partner's insurance plan. Even if you previously turned down your spouse or parent's healthcare plan because you had your own, under the Health Insurance Portability and Accountability Act (HIPAA) you have a 30-day opportunity to sign up for their plan after your employer stops contributing to your insurance.

Option 2: Continued coverage through COBRA

If you want to keep the healthcare plan you had under your employer or are not eligible for a spouse's plan, you can find out if you are protected under the COBRA law, which guarantees between 18 and 36 months of coverage for you and your family members depending upon your situation. If you are eligible for COBRA, you will get a letter from your employer or healthcare provider and have up to 60 days from receiving the notice to enroll.

People who lose their jobs between September 1st, 2008 and December 31st, 2009 and do not qualify for another health plan or Medicare, may get help from the government in paying their COBRA premiums. They will receive notice from their employers if eligible for COBRA and will only have to pay 35 percent of the premium prices. Depending upon adjusted gross income, some may have to pay back a portion or all of the assistance received once they are employed again.

Option 3: State programs

Companies who employ fewer than 20 workers are not required to offer COBRA although some states have mini-versions of COBRA that allow recently laid-off workers to stay on their employer's plan by paying the full premiums. Since February of 2009, the government has been providing assistance in paying mini-COBRA premiums as well.

Option 4: Coverage under HIPAA

Under the Health Insurance Portability and Accountability Act (HIPAA), at least one insurer in your state must offer you a health plan if you meet the following conditions: You had 18 months of coverage without a break of more than 63 days, the last day of your coverage was through your job, and you don't have a COBRA or mini-COBRA option or you have already used it up.

Option 5: Find out if you lost your job due to a trade policy

People who lost their jobs due to changes in trade policies or whose jobs were moved overseas may be eligible for 80 percent premium assistance from the government for up to three years under the Trade Adjustment Assistance Reform Act (TAARA). A new law recently increased the premium assistance from 65 percent to 80 percent until January of 2011.

Option 6: Medicaid, CHIP and other programs

Low-income families, people 65 and older and families with young children may be eligible for Medicaid or the Children's Health Insurance Program (CHIP). See Families USA "Upper Public Program Eligibility Levels for Children and Adults" (pdf) to find out if you qualify in your state.

Option 7: Private insurance

If you do not fall into any of the above categories for healthcare coverage, you can always shop for private insurance in the individual market, but do so cautiously to avoid scams and sky-high prices.

Some questions to ask when evaluating a policy:

  • What will I actually be charged in premiums, given my age and health risks?
  • How much must I pay before the insurance starts to pay for services (how big is the deductible)?
  • What are the co-payments and other out-of-pocket costs?
  • What benefits are covered? If I face an unexpected serious illness such as cancer, will this policy adequately protect me?
  • What prescription drugs are covered by the plan? Is there a formulary?

See the full Families USA report (pdf) for a complete list of suggested questions.

Also, The National Committee for Quality Assurance also posts public report cards online about plans that it accredits.

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