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If you've lost your health plan in the COVID crisis, you've got options

Julie Appleby, Kaiser Health News, Kaiser Health News on

Published in Home and Consumer News

The coronavirus pandemic -- and the economic fallout that has come with it -- boosted health insurance enrollment counselor Mark Van Arnam's workload. But he wants to be even busier.

The loss of employment for 21 million Americans is a double blow for many because it also means the loss of insurance, said Van Arnam, director of the North Carolina Navigator Consortium, a group of organizations that offer free help to state residents enrolling in insurance.

Calls to the consortium have increased sharply, but he believes many more people are going without insurance and could use his help. He suspects these newly unemployed people don't realize they have options. Years of budget cuts by the federal government have hampered outreach from nonprofit groups like the consortium, so many consumers don't understand that policies are available to help them regain or maintain health coverage.

"Large numbers of folks aren't getting the message," said Van Arnam.

Some newly unemployed people are taking advantage of special enrollment periods to sign up for plans offered on the Affordable Care Act's insurance marketplaces, while others find they qualify for Medicaid. Some might have the option to stay on their former employer's plan, even while bearing the full cost themselves.

But the clock is ticking for some of these options.

 

A Special Enrollment Period For You

The ACA is a critical backstop for many of the newly unemployed.

Under the federal health law, people who experience certain "life events" -- such as moving, getting married, having a baby or, in this case, losing your job and job-based coverage -- qualify for a special enrollment period. They can sign up for new coverage without waiting for the open enrollment period, which generally occurs near the end of each calendar year.

Applicants must submit certain documents to prove they qualify for special enrollment, such as proof of prior job-based coverage. The Obama administration in 2016 began random checks of these documents -- and the Trump administration stepped up that scrutiny -- in response to insurers' concerns that some people were "gaming" the system with special enrollments, waiting to sign up until they were sick, thus driving up health spending. The claim was controversial, with little evidence presented on how prevalent a problem it was.

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