Individuals May Have Options if They Recently Lost Health Coverage

By Cathy Aquino, Director, Government Sales | Independent Health

During this time of change and economic upheaval caused by the COVID-19 outbreak, hundreds – if not thousands – of Western New Yorkers are experiencing layoffs and job eliminations. In many cases, this means they’re also losing their employer-sponsored health insurance.

Despite losing their job, individuals affected economically by the pandemic do not have to go without health coverage: there are several alternative options ranging from $0 to low cost plans.

For some, the loss of insurance may be something they’ve never had to go through before, and they may find this situation to be a confusing and complicated process. At Independent Health, calls from people about individual coverage have more than doubled over the past couple of weeks. Since mid-March, when the local pandemic outbreak started, we’ve seen a significant increase in people enrolling in individual plans, such as Medicaid at no cost and the Essential plan which costs from $0 to $20/month, so many people who have been laid-off may qualify for these plans.

Even so, it’s likely some people may not even realize they qualify for these no-cost or low-cost plans.

While many people may be familiar with COBRA coverage, which extends employer-based coverage for a certain period of time after someone leaves an employer, it’s not always the best or affordable option.

If you or someone you know has unfortunately been affected by the COVID-19 outbreak and lost coverage, here is a very brief summary of different options that are available that may be less expensive:

  • The New York State of Health (NYSOH) Marketplace is the system established through the Affordable Care Act that people use to get health insurance coverage when they are unable to obtain or afford individual/family coverage. Unlike coverage through an employer, NYSOH determines eligibility based on someone’s income, tax-filing and household size.
  • Plans an individual (or family) may qualify for on the NYSOH include:
    • Medicaid – No premium, no copays, and prescriptions are $3 or less
    • Child Health Plus – Premiums range from $0 to $194; no copays other than $3 or less for prescriptions
    • Essential Plan – Either $0 or $20 premium, no deductible, Low copays (no copays for COVID-19 testing and treatment)
    • Qualified Health Plan – Premiums vary based on metal tier (Bronze, Silver, Gold and Platinum) and deductibles and copays vary depending on plan chosen copays (no copays for COVID-19 testing and treatment).  These plans most closely resemble employer group coverage
    • A combination of qualified health plans and Child Health Plus plans are available for those who prefer CHP for their children under 19 in addition to an individual plan for themselves
    • Subsidies and Tax-Credits are available to those who meet certain eligibility guidelines to help pay for the person’s premium

This list just scratches the surface of what’s available and the financial help people may qualify for. Coverage, benefits and copays are also important considerations, so it’s best to call the NYSOH or one of the local health plans for more information.

Independent Health is also here to help. If you or someone you know has questions about individual options, visit our website or call 716-505-8515 (or 1-855-210-9930).

About The Author

Cathy Aquino, director, government sales, is responsible for development of the sales strategy and execution to drive membership growth and retention in Independent Health’s government products. She is accountable for any sales activities’ compliance with the Centers for Medicaid and Medicare Services (CMS) regulatory mandates and state and federal marketing guidelines. Aquino brings more than 25 years of experience in the health insurance field to Independent Health. She holds a bachelor’s degree in public communications from the State University College at Buffalo.

 

Disclaimer: The above commentary entails the views of the author and not necessarily the views of the Buffalo Niagara Partnership.