Since the COVID-19 pandemic began, a record number of Ohioans have lost their jobs and for a number of them that has resulted in loss of their health insurance. While other Ohioans that were uninsured may now want to sign up for health insurance. Obtaining insurance can be a stressful and confusing experience, but the Ohio Department of Insurance can help. Here are some of the health insurance options and tips on how to secure coverage.
Possible health insurance options for Ohioans who had employer-provided health insurance:
Special enrollment into your spouse’s plan
If you recently lost coverage and are married, consider requesting special enrollment in your spouse’s group health plan. Losing coverage qualifies you (and your family) for an opportunity to enroll in many employer plans. To qualify, you must request enrollment, typically within 30 days of losing eligibility for other coverage. Check with your spouse’s plan on the required timeline, as some deadlines have been extended due to COVID-19.
Other special enrollment opportunities
Employees who’ve lost coverage may be eligible for special enrollment beyond their spouse’s group health plan. This includes any individual health insurance plan already available to them in the market, enrolling through the federal government’s health insurance Marketplace at healthcare.gov, or COBRA plans.
Ohioans who had health insurance coverage but lost coverage due to unemployment may qualify for special enrollment into a Marketplace plan on the federal government’s health insurance exchange. During the application process, you’ll find out if you are eligible for income-based savings on your monthly premiums and out-of-pocket health care costs. Your family may qualify for coverage as well. You usually have 60 days to enroll in the Marketplace from the time your employer-sponsored coverage ends. This option may not apply to people who didn’t previously have health insurance.
If you lost coverage through a job and depending on your employment situation, you may be eligible for COBRA continuation coverage. Under COBRA, a federal law, you can pay to stay on your employer’s health insurance plan, after your employment ends, for about 18 months. Your dependents may be eligible for COBRA coverage too, whether or not you sign up yourself.
COBRA is typically more expensive than Marketplace coverage and enrolling in it can change your eligibility for Marketplace financial assistance. You are responsible for payment of the full COBRA premium, and sometimes an additional administrative fee. This means you could pay more than the full premium cost. Make sure to compare the Marketplace plans and COBRA plans to ensure you’re signing up for the best plan for your family.
If you’ve lost your job or had a reduction in work hours, the sudden change in income might make you eligible for Medicaid. Medicaid eligibility is based on monthly income (adults with an annual income up to 138 percent of the Federal Poverty Level), so you may qualify even if you earned too much to qualify earlier in the year. Children may be eligible for Medicaid even if their parents are not (children in households with an annual income up to 160% of the Federal Poverty Level). Visit Medicaid.ohio.gov for more information about Ohio’s Medicaid program.
If you didn’t have health insurance before the pandemic:
The period that consumers can generally enroll in coverage without a qualifying change, known as an open enrollment period, typically occurs in the fall. However, consumers are eligible for special enrollment periods for many different reasons, such as marriage, moving, or even a significant change to income. Ohioans can call the Ohio Department of Insurance with questions about how these specifics may apply to their situation.
Ohio Department of Insurance here to help
This is certainly a difficult period for many Ohioans and shopping for health insurance can be an overwhelming undertaking. Anyone with an insurance question or concern can contact the Ohio Department of Insurance at 1-800-686-1526 and firstname.lastname@example.org.
I urge you to take your time and compare coverage along with costs to determine the plan for you and your family’s unique health care needs. And, remember the Ohio Department of Insurance is here to help.
Jill Froment is director of the Ohio Department of Insurance, 50 W. Town St., Columbus OH, 43215; Consumer Services 800-686-1526; Medicare info 800-686-1578; Fraud & Enforcement 800-686-1527; insurance.ohio.gov.