More than 6.6 million people filed for unemployment benefits last week – breaking a record for the U.S. that was set the previous week. For many, however, losing a job doesn’t just create worry about providing for their families. It also raises concerns about protecting their health during a pandemic. About half of all people in the U.S. get their health insurance through their employer, so for many people, being newly unemployed brings with it uncertainty about how to navigate their health coverage options.
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It’s important for Texans who have lost their jobs to know the Affordable Care Act (ACA) includes a provision that gives people 60 days to enroll in health care after a qualifying life event, such as job loss. There may also be options for Texans to apply for Medicaid during this time of uncertainty.
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Each program has unique characteristics and requirements as outlined below:
- Health Insurance Marketplace is for anyone who doesn’t receive employer-provided coverage, and it allows people to choose from multiple health insurance plans to find the right coverage:
- Enrollment is available during a special enrollment period (SEP). Once a person experiences a qualifying life event, such as job loss, they have 60 days to enroll.
- Financial assistance is available for Marketplace coverage if expected 2020 income will be 100%-400% of the federal poverty level, which is $12,490–$49,960 for an individual and $25,750–$103,000 for a family of four.
- To be eligible for coverage, a person must live in the U.S., be a U.S. citizen or national, and cannot be incarcerated. Healthcare.gov has more details on eligibility.
- To find out what qualifies for SEP and shop for ACA coverage, visit Healthcare.gov or call 1-800-318-2596 (TTY: 1-855-889-4325).
- Medicaid offers health insurance coverage at no cost for low-income families:
- In Texas, Medicaid coverage includes preventive care, hospital visits and medications for many low-income families, women who are pregnant, those with disabilities or chronic illnesses, and children.
- Income qualifications depend on who is applying for coverage and how many people are in the household. The Texas Health and Human Services pre-screening tool can help residents determine the kind of coverage they may be able to get. Note: CARES Act supplementary unemployment insurance benefits, which can increase benefits by $600 per week, do not impact eligibility for Medicaid programs.
- Residents may apply for Medicaid year-round, and healthcare services provided up to three months prior to becoming eligible for Medicaid can be covered retroactively.
- To apply for Medicaid, visit www.yourtexasbenefits.com.
Both Medicaid and Marketplace provide an alternative that’s often more affordable than COBRA, the health insurance program that allows people to continue their employer-provided coverage if they have lost their job. While COBRA maintains a person’s existing coverage, they will pay 100% of the cost plus an additional 2% in administrative costs. Subsidies to reduce costs are not available through COBRA, and coverage can last between 18 to 36 months. However, it will eventually expire, and a person may be required to find new coverage, either through employment, Medicaid or the Marketplace.
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