Julia Ramsey felt shell-shocked when she was laid off from her IT job in early March. She’d heard about the new virus that was hospitalizing thousands in China and Italy, but it hadn’t yet become widespread in the United States, where schools and businesses were still humming along.
“It all sort of came at one time,” said Ramsey, 38, of Glenside. “I lost my job. A couple days later the lockdown in Montgomery County happened. ... I wasn’t so concerned at first, but I quickly realized things were changing pretty rapidly.”
Not only had Ramsey lost her job, her family lost their health insurance.
Employer-sponsored health insurance is the most common type of health coverage for individuals under age 65, when most Americans become eligible for Medicare. And with millions of Americans out of work as businesses shut down during the coronavirus pandemic, analysts say the ranks of the uninsured also will rise.
Newly unemployed — and uninsured — individuals may be eligible for a plan through the federal marketplace, healthcare.gov. Others may have low enough family incomes to qualify for Medicaid.
Even if you anticipate being rehired in a few months, it’s worth finding out if you are eligible for another insurance plan, said Antoinette Kraus, executive director of Pennsylvania Health Access Network (PHAN), which helps people enroll in healthcare.gov plans and Medicaid.
“You never know when you might get sick or need health coverage,” she said.
Medicaid may be an option for people whose income has dropped to within 138% of federal poverty — $17,618 a year for an individual and $36,158 a year for a family of four.
The program uses both annual and monthly earnings to calculate income eligibility, making it relatively easy to determine if you’re eligible after losing a job. Individuals who earn less than $1,468 a month and a family of four earning less than $3,013 a month can qualify.
Unemployment pay (typically half your regular pay) counts as income, but the federal stimulus payments promised by the federal government do not.
Medicaid coverage is retroactive, but processing the application can take up to 30 days. If you have an urgent medical need, note that in your application — state reviewers may expedite your case.
CHIP, a state health coverage program with low out-of-pocket costs, is available for all children. Monthly premiums vary by household income, and families that earn up to 300% of federal poverty are eligible for a discount, said Colleen McCauley, health policy director for Public Citizens for Children and Youth, which helps families enroll children in CHIP. People who are currently enrolled in Medicaid or CHIP cannot be removed from the program during a declared public health emergency. Families already paying a premium for CHIP who have lost income should call to find out if they are eligible for a decreased rate, McCauley said.
People who lose a job with health benefits are eligible for a special enrollment period for individual and family plans sold through healthcare.gov.
Plans aren’t cheap, but are often more affordable than the COBRA payments needed to hold on to an employer-sponsored plan, and you may be eligible for an income-based tax credit — especially if you have lost your job. Individuals who earn less than $49,960 a year are eligible for some amount of tax credit.
Unlike Medicaid, which can calculate eligibility based on monthly income, the marketplace uses annual income, which may be tricky to estimate in such uncertain times.
Patrick Keenan, director of consumer protections and policy for PHAN, recommends first calculating how much you’ve earned so far this year, by looking at a past pay stub. Add 39 weeks of unemployment pay — the maximum amount of unemployment benefits allowed under the federal coronavirus relief package that was signed into law at the end of March.
During the pandemic, the federal government has suspended penalties for taking retirement funds early, but any withdrawals will count as income for those applying for healthcare.gov plans, Keenan said.
Beyond that, you’ll need to make an educated guess about how much more you may earn before the end of the year. There’s no penalty for estimating incorrectly, but Keenan said it’s important to be realistic about potential earnings. If you end up earning more than you estimated, you will need to pay back part of the discount you received when you do your taxes.
People who sign up now will have coverage that takes effect May 1.
Ramsey, of Glenside, said she was relieved to enroll in a healthcare.gov plan — even though she, her husband, and 3-year-old son don’t use much health care. At $90 a month, after a tax credit, the premium for their new plan is less than the $300 she paid through her employer, but she now has a much higher deductible — about $16,000 for the family.
“I wanted to make sure that if something happens with COVID-19, if one of us has to be hospitalized …” she said, trailing off. “The deductible is high, but it’s less than what we’d face without it.”
Pennsylvania Health Access Network assists with marketplace plan and Medicaid enrollment. Call 877-570-3642 or email email@example.com.
Public Citizens for Children and Youth assists with CHIP enrollment and can connect parents to coverage. Call 215-563-5848 ext. 17.
Center for Family Services assists with marketplace plan enrollment in New Jersey. Call 877-962-8448 or visit getcovered.nj.gov.