Written collaboratively by Lorna Saboe-Wounded Head and Maria Pippidis.
Whether the business you work for is shutting down temporarily or it needs to scale back its staff, make sure to ask your employer when your last day of health coverage it. This will help you better understand what timeline you have for your existing health care coverage. It helps ensure that you do not have a gap in your coverage when it is important to have health care coverage. There are steps you can take to ensure you have health insurance to keep you and your family healthy.
If you need to refresh your understanding of health insurance and how to choose the right type of insurance or estimate the out of pocket costs, visit Smart Choice Health Insurance, a University of Delaware Cooperative Extension website, for video tutorials and tools to help you brush up your knowledge.
Once you are feeling more confident about health insurance, consider your options.
Sign up for COBRA.
Short for Consolidated Omnibus Budget Reconciliation Act, this option allows you to retain and continue your current employer health coverage for up to 18 months. This allows your current coverage to stay the same – same doctors, networks, co-pays, and deductibles. The downside is that you will pay your entire monthly health insurance premiums yourself. That premium will include the part you usually paid plus any amount your employer was paying. You will want to find out if this option is financially feasible for you.
Sign on to Your Spouse’s Health Coverage.
If your spouse has health insurance, you may be able to be added to your spouse’s healthcare plan coverage. Have you spouse talk with their human resources department to ask what options are available. The cost of that coverage will come out of your spouse’s paycheck so before you make the decision, you may want to comparison shop.
Buy Your Own Plan on the Health Insurance Marketplace.
The Affordable Care Act introduced an online health insurance Marketplace that allows you to buy your own private plan. You are generally entitled to apply for a new plan if you lose your existing health coverage, even though the annual open-enrollment period to sign up for Marketplace plans has passed (November 1 – December 15).
You have 60 days before your current health insurance plan expires and 60 days after your plan expires. If you do not enroll during this period, you cannot enroll through the Marketplace and need to wait until open enrollment in November of each year.
In South Dakota, you can find information about this Marketplace at healthinsurance.org. The benefit of the Marketplace plans is that, depending on your income, you may qualify for subsidies and tax credits. This can reduce the cost of the premiums. There are several different plans to choose. All of them have a deductible (the amount you need to pay before health insurance pays for care) and typically the lower the monthly premiums, the higher the deductible. If you qualify for those tax credits and subsidies for the premium, that may offset the higher deductible amount and so your overall out of pocket costs may even out.
Be advised, that in order to get those credits and subsidies, you need to purchase the plans through the Marketplace or an accredited health insurance broker/provider. To find out how much of a subsidy you may qualify for you can go to HealthCare.gov. It will ask you for some information and then will direct you to the next steps.
Apply for Medicaid And/Or Children Health Insurance Program (CHIP)
Medicaid and CHIP provides free or low-cost health coverage to millions of Americans, including some low-income people, families and children, pregnant women, the elderly, and people with disabilities. If your income is low, you may be eligible for Medicaid (covers families) or the Children Health Insurance Program (covers children only). To apply, visit the South Dakota Department of Social Services website for information.
Being without health insurance during this time can be scary. Your wellbeing depends on taking the steps you need to protect your family now and in the future.