Millions of folks have lost their jobs due to the COVID-19 crisis. In many cases, they have also lost health insurance. Nearly 50% of all Americans get their health coverage from an employer’s group plan.
However, the upside is that many states are providing special enrollment periods (SEPs) for uninsured residents. If you lose health coverage, you can purchase ACA-compliant individual health insurance during a SEP.
What Is ACA-Compliant Coverage?
ACA-compliant coverage pertains to a major health insurance policy that follows the regulations presented in the Afford Care Act (Obamacare). The plans can be sold on or off-exchange. Off-exchange means the program is bought directly from the company or through an agent, outside the official ACA-created exchange.
All new individual major policies must include coverage for the 10 essential benefits (listed below) and comply with the ACA’s consumer protections.
What Are Essential Benefits?
Under the ACA, all new individual policies must cover essential health benefits for all users:
- Lab tests
- Prescription drugs
- Emergency services
- Rehabilitative services
- Maternity and newborn care
- Mental health and substance abuse treatment
- Chronic disease management and preventative services
- Pediatric services for children, including dental and vision care
- Ambulatory services (visits to doctors and outpatient hospital care)
ACA-Compliant Coverage Through Special Enrollment Period
Since the COVID-19 outbreak, some states have changed their health insurance rules. If you’re uninsured, check if your state offers a SEP in response to the pandemic. If you live in one of these areas, it’s best to enroll in an ACA-compliant plan as soon as possible. We could see more states extending their deadlines for SEPs as time progresses.
Note: If you aren’t eligible for a SEP (or Medicare), you’ll need to wait until open enrollment to purchase coverage. The plan will be implemented on January 1.
What About the Parts of Medicare?
Losing employer-sponsored insurance makes you eligible for a SEP to sign up for Medicare Part B, and then into a Part C or Part D plan. You might also be able to buy a Medigap plan if you decide to have Original Medicare.
What Else Should I Know?
- If you purchase ACA-compliant coverage today, the coverage will probably be active next month.
- Job loss leads to a lack of income, which might qualify you for Medicaid and CHIP — and you can enroll year-round.
- For those who aren’t eligible for a SEP or Medicaid, short-term health plans can protect from devastating medical expenses.
- If you contract the virus and are transferred to a skilled nursing facility to recover, you get a SEP to enroll in a different Medicare Advantage or Part D plan. Or, you may switch from Medicare Advantage to Original Medicare. This chance to change your coverage endures as long as you’re hospitalized, ending two months afterward.
Trusted Senior Specialists Can Help
During these unprecedented times, we need health insurance more than ever. We make Medicare simple through our user-friendly plans. For more information, check out our latest update about COVID-19 for people on Medicare. Or, contact Trusted Senior Specialists to find an insurance plan.