What to Do If You Lost Your Health Insurance During COVID | San Diego Health

- Hi, I'm Susan Taylor with Scripps Health in San Diego, California. Tens of millions of people have lost their jobs because of the COVID pandemic, which can also mean losing your employer provided health insurance. But there are options out there to help you get affordable health care coverage year round. Joining us to talk about this is Shawn Forrester. He is the corporate vice president of payer relations at Scripps Health. Thanks so much for being with us, Shawn. - Hi Susan, thank you for allowing me to talk to you today about this. - Sure. So what happens if you lose your job and your employer provided health insurance during this pandemic? I mean, this is scary. - It sure is. And health insurance may not be the first thing you think about when you lose your job, but I do wanna stress how important it is. Especially during the middle of a pandemic. There are some pretty critical deadlines that you'll need to be aware of. And I'll talk you through those in a few minutes. There could also be financial penalties if you don't sign up for health insurance

during those deadlines. - What is COBRA and how does it work? - So COBRA is a federal law that says employers must offer a continuation of the insurance that was offered to you through your employer. The way that would work is you have an initial 18-month period. And then at a later date, if you want to continue that plan even further, you can extend it for another 36 months. What you need to be critically aware of here though, is this is probably your most expensive option. So while you were employed and on the employer's health insurance, most likely your employer was absorbing most of the monthly premium for that insurance. You very likely had some share in that. So when you continue that insurance through COBRA, your employer may or may not continue to subsidize that cost.

If you had an employer that chooses not to subsidize that cost, your monthly premium that you pay may quadruple. - But you could be paying hundreds or thousands of dollars more per month with coverage. - Absolutely. Then what about other options? To go on your spouse or domestic partner's health insurance? - Yeah, so if your spouse or domestic partner has coverage through their employer, you can elect to go on that. That will not be free of charge, of course, but that's an option for you. And if you're 26 years old or less, you could possibly go on your parents' plan as well. - So how do you apply for COBRA or Covered California? - COBRA is not an enrollment process. So what's gonna happen with COBRA is your employer is going to give you a package that explains what is being offered to you. Generally, this is the same coverage you have

when you were employed through your employer. So the good part about that is you're not gonna have to change health plans or physicians. - And this is really good if you're undergoing medical treatment like cancer treatment and you don't wanna change your doctors. - That's right, but it's not your only option when you're concerned with continuation of coverage. In Covered California, you actually do have to apply for that. And the way you do that, is you go to their website, coveredca.com. And in Covered California, you may actually be eligible for financial assistance for their insurance options as well. In order to qualify for financial insurance, through Covered California, you will have to be between 138% and 400% of the federal poverty level. So to illustrate, if you're a single person, 138% of poverty level in, count year 2020 is $17,609.

- If you're missing that per year, okay. - Per year. If you're a family of four, that would be $36,156. Now in Covered California, as I said, it's up to 400% of the federal poverty level in order to have federal subsidies. And to illustrate, there are multiple levels tiers here, but if you're a single person it's 74,940, that would be the cutoff level in 2020. For a family of four, that would be an income of $154,500. Now these are subject to change in future years, but hopefully that helps illustrate. - And then, Covered California, how does it work? How do you apply for it? - So Covered California is the state-run public exchange for health insurance. What you would need to do is go to their website or you can call them, but most people choose to go to their website. And you will need to answer several questions. To get started, go to coveredca.com, click on get coverage, then click on shop and compare,

and then you're off and running. You'll be able to see the costs that you would need to pay for all the various plan options that Covered California has on its website. - And then if you want access to Scripps doctors, what health plans on Covered California should you look at? - Great question, Susan. So Scripps generally participates in Covered California through two health plans. One of them is health net called community care HMO. That happens to be the least expensive plan option in 2020, and in 2021 on the bronze level. Another health plan that we participate in is Blue Shield, which is offering both an HMO plan and a PPO. - And then can you apply for this year round? - Again, no, you cannot. There is a 60-day window in your qualifying period, but throughout the year, or once during the year, there's an open enrollment period for Covered California.

And that runs from October 15 through January 31st of each year. Sometimes like in 2020, because of the pandemic, that period of time can be extended through a special enrollment period. But you can't count on that every single year. That's only in special events. - And then if you're over 65 and you've lost your job, you can apply for Medicare anytime of year? - Absolutely, in fact, if you're over 65, chances are you already have Medicare part A. But when you lose your job, you'll need to sign up for Medicare part B. You will have eight months in which to do that. If you don't do that in those eight months, and you don't gain other employment, then you may incur penalties. So you're gonna want to research that thoroughly directly with Medicare. Medicare has an open enrollment period every year.

And that runs from October 15 through December 7. And during that period, you can change your health plans, you can change your coverage. You're open to select whatever Medicare plan option is out there. - And then what about Medi-Cal? I mean that's for folks, it's low cost health coverage for folks who don't make a lot of money, right? - That's right, you have to qualify for this. Your income level must be less than 138% of the federal poverty level. But the good news here is there is no enrollment period. You can sign up for this anytime during the year. You can do that through, by going to the Health and Human Services Department in San Diego in person. You could also sign up for that through Covered California, coveredca.com, or just call Covered California at 1-800-300-1506. We're happy to answer any questions that you have. We certainly wanna make sure that we can continue to see you in your time of need.

So please let us help you. - Sean, thanks so much for explaining what is a very complicated issue, that of insurance. - Thank you, Susan. - We appreciate it. Want more information about these affordable health insurance plans? Click on the link or go to scripps.org/videos. Want more critical information about your health? We take care of you from head to toe. Please subscribe to our Scripps Health YouTube channel and follow us on social media at Scripps Health. I'm Susan Taylor, thanks so much for joining us. It's our mission at Scripps to help you heal, enhance, even save your life. (upbeat music)