What to do if you lose your job-based health insurance or COBRA, what are your options?
As Mainers obey the shelter-in-place mandate from Maine’s new Governor, Janet Mills, many workers are losing their jobs, and along with their jobs, their health insurance.
Option 1 – COBRA
Over half of us get health coverage through our employer. If you get laid off, quit your job, or otherwise lose your coverage during this crisis, you have a few options for obtaining health insurance, including COBRA.
Named for the Consolidated Omnibus Budget Reconciliation Act of 1985, COBRA allows you to continue receiving the exact same health coverage you’ve been getting from your employer after leaving the company, as long as you’re not covered by another plan elsewhere.
But there’s a catch: While you’ll retain coverage at group insurance rates, you’ll have to pay both the employer’s and the employee’s portion, plus an administrative fee, which can drive up the cost of coverage way more than what you’re accustomed to paying.
How to get COBRA health insurance after leaving your job
Are you eligible for COBRA?
To be eligible for COBRA you must have left a company with 20 or more employees, or have your hours reduced.
If you have left your job or had your hours reduced for reasons other than “gross misconduct,” you’re eligible to keep your health coverage for up to 18 months as long as you continue making the premium payments.
Wait for a letter in the mail.
Your former employer is required to notify the insurance company of a qualifying event — in this case, termination or a reduction in hours — within 30 days.
After that, the plan administrator has 14 days to send you a notice in the mail with information about your coverage, where you should send your paperwork, and most importantly, how much it will cost. According to COBRA rules, the total premium cannot exceed 102% of the individual employee’s portion of the premium.
If you don’t want to wait for a letter, contact the health plan administrator or the company’s benefits manager for more information.
Sign up within 60 days.
After receiving your notice, you have 60 days to elect to receive health coverage. If your plan also covered your spouse or dependents while you worked at the company, they would be covered under COBRA also.
If you choose to sign up for a Marketplace plan and need health coverage in the time between losing your job-based coverage and beginning coverage through the Marketplace (for example, if you or a family member needs medical care), you may wish to elect COBRA coverage from your former employer’s plan. COBRA continuation coverage will ensure you have health coverage until the coverage through your Marketplace plan begins.
Make a payment within 45 days
If you elect COBRA coverage, you have 45 days to pay the first month’s premium from the date you mailed in your election form. If you pay in full and on time, you’ll be retroactively covered. If you miss the payment, you could lose your ability to receive COBRA coverage entirely.
Coverage can last up to 18 months from the initial qualifying event (the date you were laid off). If your monthly premiums aren’t paid in full and on time, the employer stops offering a group health plan, you become entitled to Medicare, you become insured by another plan, or you engage in fraud or otherwise shady conduct, your coverage could be terminated.
Option 2 – Healthcare Marketplace Plans
You can apply for health coverage, compare all your options, and enroll in a plan in one streamlined application through the Health Insurance Marketplace. When open enrollment begins in November or if you qualify for a Special Enrollment Period.
Step 1. CLICK HERE to see the plans.
Go to www.MaineInsuranceOptions.com to find out what the plans cost and which plans cover your doctors and hospitals.
Step 2. Enter your Zip Code.
Enter your zip code to see the plans available in your state. Each state offers different plans and different rates. Enter the zip code for the city where you live.
Step 3. Pick a plan
Step 4. Enroll
Choose a health insurance plan that meets your needs and enroll!
If you need help with your Marketplace application, there are people trained and certified to help you understand your health coverage options and enroll in a plan in every state. And remember that you can contact us anytime for help with a Marketplace question. Just use the simple form below.