If you are recently unemployed, you may be in the process of finding health care coverage on your own for the first time. Understanding what each health plan means and what it offers may be a good first step in making coverage decisions that are right for you and your family.
To help you with this process, here is a list of some of the more common health care plans and their definitions.
If you used to have an employer-based plan, you may be able to keep your current plan under a federal law known as COBRA. You will have to pay the full insurance premiums, which includes the portion paid by their former employers, but your benefits remain the same. COBRA covers workers in firms with at least 20 employees and coverage is temporary – usually up to 18 months. Check with your COBRA administrator to learn more about enrollment deadlines and end dates.
Coverage on Someone’s Plan
You may be eligible to get coverage under someone else – through a spouse or domestic partner or through your parents’ plan, if you are under 26. In either case, reach out to your human resources/benefits department to determine eligibility for coverage, benefits and cost.
Individual ACA Plans
This insurance plan meets the requirements of the Affordable Care Act (ACA), including coverage of specific medical care. While enrollment in these plans usually is limited to the fall, individuals may qualify for a special enrollment period, as in the case of losing one’s job. Also based on your household size and income, you may be eligible to receive premium subsidies, as well as savings on deductibles, copayments and other out-of-pocket costs, to help make these plans more affordable.
Medicaid or CHIP
Medicaid is a federal- and state-level program that helps with medical costs for eligible, low-income adults, children, pregnant women, elderly adults and people with disabilities. Because it’s run by your state, your eligibility depends on the state in which you live. Medicaid programs are designed at the state level and most health care costs are covered for a person who qualifies for both Medicare and Medicaid.
Children’s Health Insurance Program (CHIP) is an all-encompassing benefit program, providing primary care, dental care, behavioral health services and vaccinations for children from birth to age 19. Eligibility for the program is most often determined based on families’ financial situation.
Medicare is a federal program that offers health insurance to people over 65 or with a qualifying disability. It has four main parts – A, B, C and D. Parts A and B cover in-patient and out-patient care. Part C (Medicare Advantage) combines Parts A and B into one plan and often includes Part D prescription drug coverage and other benefits.
These plans provide coverage if you’ve recently become unemployed or otherwise have lost coverage, helping fill the gap until you can enroll in longer-term insurance coverage. These plans generally have lower premiums than ACA health insurance plans but offer fewer benefits because they don’t have the same coverage requirements. These plans have a fixed duration of a few months to several years.