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Coronavirus restoration: how to get health insurance now

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If there is a time when individuals in particular need access to quality health care and health insurance, this happens during a global pandemic.

But in the United States, 33.5 million people still have to apply for unemployment benefits, and most people in the country get their health insurance through their jobs. An analysis by the Caesar Family Foundation released Wednesday estimates that 27 million people have recently lost their health coverage.

The good news is that the report also found that the vast majority of those who lost their insurance could still be covered by switching to a spouse plan, or were eligible for subsidized health insurance elsewhere, either through Medicaid. or through an Obamacare insurance swap plan.

"For me, the conclusion drawn from this report is that the Affordable Care Act works like a safety net it was supposed to be," says Sabrina Corlette, co-director of the Center for Health Insurance Reform at the Georgetown University. "Of course, the absolute irony is that she does this job as the Trump administration argues before the Supreme Court that it should be abolished."

The question now is how many people who lost their coverage will already be enrolled in a new plan. Health insurance is complicated and underwriting can be difficult. "There is a lot of pressure on people right now," says Larry Levitt, executive vice president of health policy for the Kaiser Family Foundation and author of the report. "You may be unemployed, you may be sick, and you may be quarantined, and there is a limit to how many things you can handle at one time."

The clock keeps ticking. If you lose coverage due to job loss, this is called a "Qualifying Life Event." You can go to Healthcare.Gov or change the insurance in your country now to sign up for a new plan.

But this should happen within 60 days of losing coverage, especially for people who lost their employer-based insurance in early March, there is no time to lose. Here is a guide to some of the options available to you if you are one of the millions who recently lost your job and your health insurance:

I was fired and got insurance during my job

You may be able to maintain the same health plan under federal rules known as COBRA, if you work for an employer with 20 or more employees. One of the advantages of Cobra, says Levitt, "is that it provides greater continuity of coverage, because it stays in exactly the same plan that you were working on when you worked: the same network of doctors and hospitals, the same discount, everything is identical " But this continuation of current health coverage can be very expensive, because at least under normal circumstances, you will have to pay the full monthly premium, without being cut by the employer to make it more affordable. Your insurance company must inform you if you have a charge option and have 60 days to choose it. (For those who lost coverage in March, the clock is ticking to choose this option.)

The next place to be seen is the insurance exchanges created under the Affordable Care Act. Losing the health insurance you got through your job is an "eligible event" to enroll in a plan at all health insurance exchanges. This means you can go to Healthcare.gov or the state exchange and buy a new plan. The Kaiser Family Foundation has a useful benefit calculator so you can see what you might be paying in the fees for these plans; remember that your unemployment benefits are counted as a listing on the stock market. Again, you only have 60 days to choose this option after losing coverage (unless you live in a state that has created a special registration period), so be sure to register for that time period.

If your income is eliminated through lost work, you should also check to see if you qualify for Medicaid, the national low-income health insurance program that is co-funded by the federal and state governments. Medicaid is registered year-round and is based on monthly income rather than annual income, and is primarily free to eligible individuals. You are likely to be eligible if you live in one of the 37 states and the capital city that have expanded Medicaid under the Affordable Care Act.

You're already unlocked

Your coverage options if you are one of the approximately 28 million Americans who were uninsured, even before the COVID-19 crisis, depended on where you live. Medicaid may work for you, but eligibility rules (including income cuts) vary by state. Countries that have not expanded Medicaid, the way Obamacare has expanded its coverage to 12 million previously uninsured people, have more restrictive rules for those eligible. According to the Kaiser Foundation, nearly 6 million adults are already eligible for Medicaid prior to COVID-19, but have not enrolled.

If you are not eligible for Medicaid, take a look at the government insurance exchanges created under the ACA. The Trump administration decided not to open a special registration period for Healthcare.gov, the Federal Insurance Exchange. But some states have their own insurance markets and have created a special registration period during the coronavirus crisis. In these states, including hardest hit places like California and New York, this means you don't need a "qualifying event" like losing job coverage or giving birth to a child to enroll in the Obamacare plan now.

It's worth checking to see if you can sign up and get an affordable plan: According to KFF, more than 4 million people who were uninsured before the Coronavirus crisis would be eligible for an ACA-backed health plan that won't cost them anything in their monthly insurance premiums.

One thing to note is that Congress has put funding in some emergency funding bills that could help hospitals and health systems pay the costs of COVID-19 to the uninsured. "While the uninsured may continue to receive bills from service providers, [these federal funds] will help reduce the burden on patients because hospitals will be partially offset by their costs," says Corlet of the University of Georgetown.

White House officials have cited this funding as a reason that may make the federal special registration period unnecessary. The White House notes that uninsured patient bills related to COVID-19 can be forgiven by doctors and hospitals. Many details about how these federal funds are distributed are still up in the air, and are limited to coronavirus care and testing.

"While COVID-19 is currently a major risk on many people's minds, people have health care needs that go beyond the coronavirus." Levitt's Notes. If you end up with cancer, for example, or an appendix plus and you're uninsured, it could be financially damaging, so health policy experts always recommend coverage if you can.

My children also lost their coverage.

There will be many people, over 5 million, who will not get insurance that they can afford, even with the options mentioned above. If you can't get an adult health plan in your family, your children may still be able to get coverage; the rules differ for them and for pregnant women. InsureKidsNow.gov is a good place to start to determine if your children are eligible.

What about short or "thin" plans?

Short-term health insurance plans were originally designed to be used only for several months, to tilt people between the end of school and the start of a new business, for example. Since then, the Trump administration has promoted these plans, and their more affordable monthly installments, as good long-term alternatives.

But plans often have limitations on what they cover more than ACA plans. They are allowed to restrict registration to those who do not have pre-existing conditions, for example, and do not have to cover all the "basic benefits" included in all Obamacare plans. "They can exclude prescription drugs and they can cover the amount they will pay at the hospital," says Levitt. "So if you look at one of these short-term plans, you really want to read the subtle details."

Once I am blocked, what is covered at the time of coronavirus infection?

Congress requested that insurance companies cover the cost of a coronavirus test (although tests are not always available). Less obvious is how much it will cost you to treat if you become seriously ill and need a hospital stay for COVID-19.

Hospital and emergency care is a key benefit and should be covered, but patients may still have to meet their annual policy discount and pay for things like prior copyrights and coins. Some large commercial insurance companies have committed to reducing the costs of these patients for the treatment of COVID-19, and many non-profit community health plans have done so. Levitt notes that the limited availability of diagnostic tests can make it difficult to demonstrate that you are eligible for these benefits.

Unfortunately, sudden bills are still a concern - bills that come directly from out-of-network hospitals or from the doctors who treat you. Based on 1 KFF analysis, approximately 1 in 5 hospitalized pneumonia cases generates a sudden bill. Members of Congress may try to address this in future coronavirus legislation, but until they do, it will continue to be how people will be exposed to high medical expenses.

If you receive a surprise bill for a COVID-19 treatment, the same old advice applies (this will be familiar to those who follow the NPR bill series): Call the hospital, doctor, or insurance company and try to negotiate a lower bill. If they aren't moving, check with your doctor or hospital to see if they can help you with a payment plan or debt forgiveness as part of a charity care program.
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