Know Your Health Insurance Options if You Lose Your Job
We understand this can be a frightening time
With the economy upended by COVID-19, some businesses are downsizing. Many people are suddenly left without work — and without health insurance.
We understand that the loss of health insurance can be frightening. When you live without insurance, even the most basic care can take a financial toll. So, one of the first things you should do at this time is to explore ways to obtain coverage. The following are eight options that could help you get health insurance during these difficult times:
Coverage through a spouse
If you’re married and your spouse has a coverage option through their work, typically the most affordable option is to have your spouse add you and your family to his or her plan. Or, if your spouse is not currently enrolled in the coverage option through their work, they could sign up for it and then add you and your family. But don’t delay because there is a 30-day special enrollment period in which to make the change. After that, you and your family won’t be able to join the plan until the standard open enrollment period at your spouse’s company. If you’re under age 26, you may even be able to join your parents’ employer-based plan.
Look at the Health Insurance Marketplace (or “exchange”)
The Health Insurance Marketplace (also known as the exchange) is a service that helps you shop for and enroll in affordable health insurance. Mass., R.I. and N.H. each have their own Marketplace options.
Massachusetts offers health plans from leading insurers over the Massachusetts Health Connector. In response to COVID-19, the Connector is making an extended enrollment period available through June 23, 2020, for qualified Massachusetts residents who are uninsured.
Tufts Health Plan offers two high-quality health plans through the Connector:
- Tufts Health Direct – our focused-network plan for individuals and families. Members can access affordable ConnectorCare plans and other financial help programs. For more information, visit Tufts Health Direct or call 888.257.1985.
- Tufts Health Premier – affordable HMO plans with a variety of benefit options. For more information, call 800.462.0224.
You can learn more about the Connector here or by calling 877.623.6765.
Rhode Island offers health plans through HealthSource RI, which is making a special enrollment period (SEP) available through April 30, 2020, to qualified individuals who are uninsured. Those completing an online application should indicate that they have experienced an "Other" SEP event and note the coronavirus as the explanation. Coverage will begin on the first of the month following the application. For more information, contact the HealthSource RI call center Monday-Friday, 8 a.m.-6 p.m. at 1-855-840-4774.
New Hampshire offers the Granite Advantage Health Care Program. Coverage for individuals in Granite Advantage is provided through New Hampshire’s Medicaid Care Management Program (MCM) plans. The program is for adults ages 19-65 who fall under certain income limits and need health coverage. You can enroll in the Granite Advantage Program through NH Easy.
Shop for an “off-exchange” plan
“Off exchange” describes a health insurance plan that you buy directly from an insurance carrier or through a licensed broker outside of an official state or federal Health Insurance Marketplace (or Exchange). All such plans are "guaranteed issue,” which means that the carrier cannot deny coverage because you have a preexisting medical condition or because they expect that you will use a high amount of medical services.
For information on the carriers that offer plans to individuals in Massachusetts, including Tufts Health Plan, visit our partner agency, HSA Insurance.
Are you eligible for Medicaid or MassHealth?
Medicaid is a public assistance health program for low-income Americans regardless of their age. In Massachusetts, the program is called MassHealth. It provides free or low-cost health coverage to individuals, families and children, pregnant women, the elderly, and people with disabilities. Many states have expanded their Medicaid programs to cover all people below certain income levels. Mass., R.I. and N.H. all offer expanded coverage to low-income adults.
Tufts Health Plan offers three Medicaid plans:
- Tufts Health Together – (Our MassHealth plan). Members get all the benefits of MassHealth, including visits to doctors and specialists, prescription drugs for kids, eye exams, and eyeglasses. For more information, visit Tufts Health Together or call 888.257.1985.
- Tufts Health RITogether – (Our R.I. Medicaid plan). Members get all the benefits of Rhode Island Medicaid and more, including discounts, perks, and health coaching. For more information, visit Tufts Health RITogether or call 866.738.4116.
- Tufts Health Unify – (Our Medicare-Medicaid One Care plan). Members get all the benefits of MassHealth and Medicare, plus a care manager, a personalized care plan, and long-term services and supports. For more information, visit Tufts Health Unify or call 855.393.3154.
You can learn more about the Medicaid program here.To learn more about Medicaid, visit MassHealth, HealthSource RI or One Care.
Opt in to COBRA
COBRA (the Consolidated Omnibus Budget Reconciliation Act) can provide a good bridge until you find new employment with health insurance benefits. If you lose your job or experience a reduction of work hours, COBRA enables you to continue your same group insurance plan for 18 months. No changes can be made to your plan during this time. However, those who lose their jobs because a company goes out of business might not be eligible for COBRA if the company stops its group insurance plan.
You have 60 days to enroll in COBRA once your health insurance benefits end. However, COBRA coverage can be expensive because your former employer likely will no longer be paying a portion of the health insurance premium and you’ll be required to pay 100% of it, plus an administrative fee.
COBRA is for businesses with 20 or more employees. Massachusetts, Rhode Island and New Hampshire each have their own state-supported versions of continuation coverage as well:
- Massachusetts has a “Mini-COBRA” law that provides continuation of coverage if you worked for a small business with 2-19 employees. In most cases, you have 60 days to elect coverage.
- Rhode Island has an Extended Medical Benefits statute. This means that even if you do not meet the requirements for federal COBRA insurance, you may still be eligible for continuation of coverage in Rhode Island.
- New Hampshire – State Continuation allows you to continue coverage if your group health plan is fully insured and you are a New Hampshire resident. State Continuation applies to employers of any size.
Explore CHIP for children
The Children's Health Insurance Program (CHIP) provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid. You can learn more about CHIP and how to apply here.
Community health centers can help
Community health centers, which provide care to people without health insurance, have sliding fee scales based on income. These centers can be found in many parts of the country and are regulated by the federal government. Many centers also offer counseling services to help people find health insurance or low-cost care.
You can find more information about health centers here.
Are you a veteran?
Eligible veterans can apply for health care benefits through the U.S. Department of Veterans Affairs. You can learn more here.
Medicare may be an option
If you are 65 or over and recently lost your job, enrolling in a Medicare plan may be your most cost-effective option for health coverage - even compared to COBRA. Our Medicare Experts can help you review your options and select the plan that fits you best. Learn more about Medicare insurance or call 1-800-890-6600 (TTY: 711).
At Tufts Health Plan, we hope this information about health insurance options is helpful to you during these difficult times.