What happens when you lose your health insurance, and what are your options? Find out here.

1. What is COBRA, and how can it help me?
2. What is the Affordable Care Act, and how can it help me?
3. What is short-term medical insurance, and how can it help me?
4. What is Medicare, and how can it help me?
5. What is Medicaid, and how can it help me?
6. What’s my best option if I lose my insurance?

If you left your full-time job with benefits, either by your choice or someone else’s, figuring out your health insurance options can be overwhelming. And the type of plan you look for might depend on how long you think you’ll need it for, whether you receive care for an existing health condition, and your budget.

Between the Affordable Care Act (ACA) and continuing with your former employer’s plan (i.e., COBRA, which stands for the Consolidated Omnibus Budget Reconciliation Act), your options might seem endless, with the perfect plan in reach. Although not as comprehensive as ACA or employer-sponsored plans, short-term medical insurance may also be an option.

But even the professionals can’t agree on the best health insurance plan. “I am convinced that my best efforts at choosing plans will not guarantee that I picked the perfect plan for my family,” says David Anderson. He’s a research associate at Duke Margolis Center for Health Policy in Durham, North Carolina. “Instead, my goal is to avoid catastrophically bad choices and instead find something that is good enough. This should be the goal — avoid bad and find good enough.”

Read on for an explanation of the different types of health insurance plans available to you.

Need a health plan for you or your family? Explore your insurance policy options now, or contact a licensed insurance agent at 1-844-211-7730.

What is COBRA, and how can it help me?

Shortly after you leave your company, you may receive a notice in the mail about staying on your company’s health plan. This is called COBRA. Technically, that stands for the Consolidated Omnibus Budget Reconciliation Act, but everyone calls it by its acronym.

If you’re an employee at a company, COBRA allows you and your family to stay on the company’s group insurance plans, even if you don’t have your job anymore. The intention of the act is for people to have insurance coverage while they search for a job or wait for the benefits at a new job to kick in. You can qualify for COBRA whether you leave the company voluntarily or are asked to leave (except in situations of “gross misconduct”).

Your children can also opt for COBRA if they no longer qualify for the group plan. They could become disqualified for coverage, though, if they reach a certain age (usually 26).

The pros and cons of COBRA

You usually have at least 60 days to file the paperwork to stay on your employer-sponsored health insurance plan. If you decide to stay on, the coverage will be backdated to the day when you left your company.

Though you have to sign onto the COBRA plan within 60 days, you don’t have to keep the plan for the full 18 months you’re eligible for it. (Under certain circumstances, COBRA can last up to 36 months.) You can stop paying the monthly bill (premium) and leave the plan when you get new health coverage.

One big issue with COBRA is that it can be expensive. Employers can charge COBRA participants the entire cost of the plan plus a 2% administrative fee. Many people find more affordable options elsewhere.

That said, COBRA can be a convenient option if you just need coverage for a short time. For example, if you have another job lined up, it can be easier just to pay a month or two of premiums than to shop around and qualify for temporary health coverage. COBRA is also an option if you have pre-existing health conditions and won’t qualify for a low-cost, short-term health insurance plan. More on those in a bit.

What is the Affordable Care Act, and how can it help me?

The Affordable Care Act (ACA) is a federal law that aims to make health insurance accessible to all Americans. All ACA-qualified plans come with coverage for 10 essential benefits, which include:

• Ambulatory patient services (care you get after being admitted to the hospital)
• Emergency services
• Hospitalization (such as surgery and overnight hospital stays)
• Pregnancy, maternity and newborn care (both before and after birth)
• Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
• Prescription medications
• Rehabilitative and habilitative services and devices (to help you regain or recover mental or physical skills if you were injured or have a disability or chronic condition)
• Laboratory services
• Preventive care and wellness services and chronic disease management
• Pediatric services, including oral and vision care (adult dental/vision coverage is not included)

Additional benefits include coverage for birth control and breastfeeding.

You may qualify for a premium tax credit, a type of monthly cost reduction, to help pay for the cost of the plan. For example:

• If your income is between 100% and 400% of the federal poverty levels (FPL), you’ll qualify for premium tax credits in all states that will lower your monthly insurance bill for an ACA plan. However, if your income is at or below 150% FPL, you may qualify to enroll in or change your coverage through what’s called a Special Enrollment Period (SEP). This is a special window that opens for you to enroll or change your insurance.
• If your income is above 400% FPL, you may still qualify for premium tax credits that lower your monthly insurance payment for a 2024 ACA plan.

The pros and cons of ACA plans

The Affordable Care Act does have some advantages over COBRA. First, you have the choice of any plan available in your area. On COBRA, the only choice is to continue the employer plan, which might be expensive without the employer paying a portion of the costs.

It’s possible to find a plan that’s a better fit for your needs. Depending on your income, you can get government help with paying your monthly insurance bill and potential help with copays and coinsurance.

But you must enroll in an ACA plan during an enrollment period. Open Enrollment is every year from November 1 to January 15. During this period, anyone can choose a new plan or change plans.

The only way around that is if you experience a qualifying life event, which can open an SEP. You’ll qualify for an SEP if:

• You get married
• You get divorced or legally separated and lost insurance
• You have a baby or adopt a child
• Someone on your health insurance policy dies
• You move
• You turn 26
• You become a U.S. citizen

You’ll also get an SEP if you lose your employer-sponsored health insurance. In this case, you’ll have 60 days to enroll in an ACA plan. Don’t miss that window or you’ll have to wait until January to apply for health insurance.

It’s important to understand that health insurance companies offer different plans. That means that if you buy your ACA plan from a different company than the one your former employer used for health insurance, your network and benefits might be different. So, your kids’ pediatrician might not be in your new network, for instance.

If you take your children to that same pediatrician and they’re out of network on your new plan, you may get a big bill. Similarly, your plan costs and the coverage might be different. So, it’s always good to review your insurance company’s brochure or call the company to figure out what’s covered and what isn’t.

A great way to get short-term health insurance for you or your family? Enter your ZIP code to search available plans, or call a licensed insurance agent at 1-844-211-7730.

What is short-term medical insurance, and how can it help me?

Short-term health insurance plans are provided by private companies. They’re a type of insurance that can cover you for a limited amount of time.

But it’s important to know that short-term medical insurance isn’t comprehensive coverage. It neither meets all the minimum requirements for health insurance under the ACA, nor provides essential health benefits.

While in the past, they’ve provided a longer alternative for people who might be between jobs or who missed ACA’s Open Enrollment Period, the rules regarding them have recently changed. Under the new rules, which go into effect on September 1, short-term insurance will only be able to cover you for no more than 3 months, with a maximum coverage period of no more than 4 months in a 12-month period, taking into account any renewals or extensions.

It’s worth noting that if you get or renew a short-term plan before September 1, your coverage may continue to have a term of just under 12 months, with a max of up to 36 months. Those rules may be different depending on which state you live in though.

Either way, it’s a good idea to check with your insurer before buying a short-term insurance plan.

The pros and cons of short-term insurance plans

These plans often have low monthly premium costs, making them an attractive option to healthy individuals who want some protection. Maybe you want an option other than what has already been presented — or you’re just looking for coverage while you’re between jobs.

But some short-term plans provide limited coverage — and as is noted above, the rules are changing regarding how long they can cover you for (a max of 4 months in a 12-month period), with the changes going into effect on September 1.

On the pro side, you can typically apply for coverage anytime. There’s no Open Enrollment window that will close on you or that you’ll have to wait for to open. These plans can also come with lower monthly payments than other insurance plans. One reason for the lower price tag is that they don’t guarantee acceptance to everyone.

Underwriting is the process the health insurance company uses to review an application to determine if the applicant is insurable. The application may include questions about lifestyle and previous diagnoses. Some may even require a medical exam.

When comparing short-term plans, it’s important to look at the list of exclusions. Some plans don’t cover injuries resulting from high-risk activities such as skydiving or horseback riding. You might also find that some services such as mental health counseling or organ transplants aren’t included with those plans.

If you have a pre-existing condition, such as diabetes or cancer — and you need more than regular doctor visits — a short-term plan probably isn’t right for you.

When comparing plans, pay attention to the full price of care too. While short-term plans can come with low monthly costs, they can have high deductibles. The deductible is the amount that you must pay out of pocket for care before your health insurance starts covering eligible expenses.

Want to explore a short-term medical plan? Take a glance at the benefits and compare plans, or contact a licensed insurance agent at 1-844-211-7730.

What is Medicare, and how can it help me?

Medicare is a government-sponsored health program that offers coverage if you’re 65 or older, or if you have certain disabilities or end-stage renal disease. Most people get Medicare Part A (hospital insurance), and you normally have to pay for Part B (medical insurance) too. (You might see Medicare Parts A and B referred to as Original Medicare.)

So, if you leave your job and either of those factors applies to you, Medicare can help you get covered. You can enroll even if you plan to keep working.

What is Medicaid, and how can it help me?

Let’s say you lose your job and have little or no income coming into your household or you have a disability. Another way of getting health coverage could be through Medicaid, the largest source of health coverage in the United States. Among others, it provides coverage to:

• Individuals with disabilities receiving Supplemental Security Income
• Low-income adults and families
• Pregnant women

Each state has its own income eligibility levels, services that it covers and other rules. So, make sure you check your state’s rules: You have to provide proof of your income level before you join Medicaid. (Note: There’s no income limit for people with disabilities.)

To see if you’re eligible, you can check your state’s website or go to the federal Medicaid site.

What’s my best option if I lose my insurance?

Your best option will depend on several factors, including your:

• Age
• Health status
• Income

If you’re under 65, Medicare is mostly off the table. But you have other options, such as an ACA plan or COBRA.

And don’t despair. There are people whose job it is to help you figure out how you can get covered. They may even be able to help you save money or get benefits that cost little or nothing at all (see: Medicaid).

“Insurance is tough to choose, so get help from people who know insurance and know the language and assumptions that insurers use,” says Anderson.

Wondering which short-term health plan might be right for you? Get more insurance policy details now, or call a licensed insurance agent at 1-844-211-7730.

This article contains information that is compiled by UnitedHealthcare or its subsidiaries. UnitedHealthcare does not represent all the information provided are statements of fact. Please consult directly with your primary care physician if you need medical advice.

Sources:

Centers for Medicare & Medicaid Services. “How did the American Rescue Plan (ARP) and the Inflation Reduction Act change Marketplace premium tax credits?” September 5, 2023. Retrieved from https://www.agentbrokerfaq.cms.gov/s/article/How-does-the-American-Rescue-Plan-ARP-change-Marketplace-premium-tax-credits

Centers for Medicare & Medicaid Services. “Short-term, limited-duration insurance and independent, noncoordinated excepted benefits coverage (CMS-9904-F) fact sheet.” March 28, 2024, Retrieved from https://www.cms.gov/newsroom/fact-sheets/short-term-limited-duration-insurance-and-independent-noncoordinated-excepted-benefits-coverage-cms

HealthCare.gov. “Premium tax credit.” Retrieved from https://www.healthcare.gov/glossary/premium-tax-credit/ Accessed April 5, 2024

HealthCare.gov. “Special Enrollment Periods.” Retrieved from https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/ Accessed April 5, 2024

HealthCare.gov. “What Marketplace health insurance plans cover.” Retrieved from https://www.healthcare.gov/coverage/what-marketplace-plans-cover/ Accessed April 5, 2024

Medicaid.gov. “Medicaid eligibility.” Retrieved from https://www.medicaid.gov/medicaid/eligibility/index.html Accessed April 5, 2024

U.S. Department of Labor. “FAQs on COBRA continuation health coverage for workers.” Retrieved from https://www.dol.gov/sites/dolgov/files/EBSA/about-ebsa/our-activities/resource-center/faqs/cobra-continuation-health-coverage-consumer.pdf Accessed April 5, 2024

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