Losing Medical Coverage? You Have Options

Losing Medical Coverage? You Have Options

If you or a loved one are among the millions of Americans losing employment, we extend our heartfelt sympathy and best wishes for rapid re-employment. Since you may now need to deal as an individual with medical coverage, we’re expanding below on some alternative means of obtaining coverage at a reasonable cost.

Option 1. The first thing you need to be aware of is COBRA. The Consolidated Omnibus Budget Reconciliation Act of 1985 requires employers to offer continuation coverage to individuals losing group coverage due to separation from a company. However the employer also goes out of business, NO COBRA coverage needs to be offered.

There are many sources of information on COBRA benefits; you might start with Department of Labor regulations, here. The process begins with the employer presenting the employee with an offer of continued coverage, including the cost of coverage and time allowed for response. You may be shocked at how high the cost is.

The COBRA offer will normally require you to reimburse the employer on a monthly basis for his full cost of your coverage, plus an administrative charge of up to 2%. An ex-employee is able to elect coverage for up to 18 months—depending upon the size of the employer group.

Here’s a silver lining: you can utilize the response time to “ride” coverage, while seeking new employment and/or looking for other coverage—effectively providing you free coverage for a period of two months or so (depending on specific circumstances).

Option 2. Individuals who have NO coverage can receive care by showing up unannounced at major hospitals and WAITING for free treatment—just as they always could. (They are no longer required to sign up for ACA/Obamacare.)

Option 3. Healthy individuals desiring “inexpensive” full coverage should look first at short-term insurance. Short-term policies require positive responses to several logical key medical questions and are limited to 12 months of coverage. You can select the number of months you need. By screening out serious medical conditions and limiting time exposure (lest serious conditions arise during the period of coverage) a number of quality companies are able to offer individuals coverage at up to 80% less than ACA or corporate plans.

You can obtain a short-term quote and application HERE. (Linking coverage to Wayne is a no-cost feature, allowing him to interface with the insurance company to assist the insured individual during the policy period—but only if desired and requested by the policyholder.)

Option 4. Less healthy individuals will usually find the best care through ACA (“Obamacare” – officially the “Patient Protection and Affordable Care Act,” or “PPACA”). Its plans cover nearly everything and do NOT exclude pre-existing conditions.

The next opportunity to apply for guaranteed-issue coverage under ACA is the open enrollment period November 1 – December 15, 2020. However, special conditions—including losing group coverage in an employer layoff—allow application at other times.

If you’re interested in ACA coverage, start HERE.

If interested in other medical care ideas, including for businesses, click here.

(Wayne Peterson publishes this blog weekly on his website.)

Legal Disclaimer: Material in this blog is for information purposes only and is not intended to be an offer or solicitation for the sale of any financial product or service or a recommendation or determination that any investment strategy is suitable for a specific investor. This information is not intended to provide financial, tax, legal, accounting or other professional advice since such advice always requires consideration of individual circumstances. This blog does not constitute an offer to sell any securities in the United States. We will not be liable for any financial losses which might occur as a result of your use of this material.


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