COVID-19 is causing a lot of uncertainty, including how to maintain health care coverage amid the pandemic’s widespread economic impact.
The good news — so far — is that most people who have lost jobs or income say they are still insured, according to an April poll by the Kaiser Family Foundation.
But the poll also found that 4 in 10 Americans said they’d experienced a loss of employment or income because of the outbreak.
Meanwhile, the prospect of needing health care amid the outbreak may be causing some people to look for coverage now if they previously opted out.
The options for finding health coverage depend on each person’s specific situation. Here are a few common scenarios.
When people lose job-based coverage, they qualify for a special enrollment period (SEP) to buy health care coverage for themselves and their family members outside of the annual open enrollment window that typically takes place between Nov. 1 and Dec. 15.
Depending on their household income and family size, they may also be eligible for financial assistance with premiums and reduced out-of-pocket costs for these plans.
A variety of changes in people’s lives — not just job loss — may trigger an SEP that lasts 60 days from the time of the event. For example:
- A decrease in work hours
- Moving to a new ZIP code or county
- Getting married or divorced
- Having a baby or adopting
- Turning 26
Enrollment is allowed within 60 days of a qualifying life event.
Learn more about enrolling in individual and family plans.
Under the federal law known as COBRA, people can choose to continue their employer-based coverage within 60 days of becoming ineligible for benefits if they lose their job or their hours are reduced.
Under COBRA, the member may have to pay up to 102% of the premium cost — including the share that the employer used to pay. Choosing COBRA coverage ensures members are able to keep their employer’s health care coverage and current network of doctors and hospitals.
People who choose COBRA may later enroll in an individual or family plan during open enrollment or when COBRA runs out.
A family member’s plan
Young adults who lose their health insurance at work can join a parent’s health plan until they turn 26.
People who lose employer-based coverage may also be able to get group coverage through a spouse’s employer plan outside of the open enrollment window.
Medicaid and CHIP
States provide free or low-cost health care coverage through Medicaid and the Children’s Health Insurance Program (CHIP) in partnership with the federal government.
Eligibility varies from state to state and may depend on age, income level or if a person is pregnant, has a child or has a disability.
People who are eligible for Medicaid or CHIP may enroll at any time during the year.
Learn more about Medicaid and CHIP eligibility in New Mexico.