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By Massachusetts Health Connector
| July 20, 2020
The COVID-19 pandemic has created a seemingly limitless list of unique situations for Americans, including one for the millions of unemployed — finding their own health insurance.
For most people in the United States, health insurance comes from their employer. In most cases, the employer pays for a significant part of the coverage, and either selects the plan or gives employees a narrow range of options to choose from.
Suddenly, due to the coronavirus, millions of Americans have lost their jobs, and with it they have lost their access to health care — at a time when needing services may be more important than ever with insurers covering the cost of COVID-19 testing and care.
With that loss of coverage comes a deluge of questions. Where can I get coverage on my own? Why does it cost so much? Do I really need health insurance? And many, many more.
The Massachusetts Health Connector is the Commonwealth’s state-based health insurance exchange. It is where people who don’t get health insurance from their work can get their own coverage. Currently, nearly 300,000 residents get health insurance for themselves and their family through the exchange.
In the last few months, the Health Connector has heard a number of questions from people who are looking for their own health insurance for the first time. Here are some of the most common questions, and answers from navigators, community-based assisters who are trained to help people who are finding health insurance on their own.
I just lost my health insurance. What are my options?
Generally, people can elect to keep their work coverage through COBRA, they can connect directly with a health insurance carrier, or they can go the Massachusetts Health Connector to seek out coverage.
“Right now, through an extended enrollment period, anyone without health insurance can enroll in coverage through the Health Connector,” says Tina Alu, executive director of the Cambridge Economic Opportunity Committee, a Health Connector navigator. “It’s also the one place where they can find help paying for their plans, which is important after losing coverage that was partially paid by their employer.”
Do I really need health insurance right now?
Massachusetts has in place an individual mandate, requiring adults to have insurance or face the prospect of a tax penalty when doing their income taxes. While there is some cushion to not have coverage – three months – before incurring a penalty, waiting isn’t the best idea.
“People in Massachusetts understand the need for health insurance, and the health and financial benefits of having coverage. That’s why we lead the nation with 97% of all of our residents covered,” says Caronanne Procaccini, director of client self-sufficiency at the Community Action Committee of Cape Cod & Island, a navigator organization. “Having coverage means you can go to the doctor, and avoid big bills if you are suddenly sick or injured. And having COVID-19 tests and treatment covered at no cost is very important right now.”
I have chronic conditions that mean I need to go to the doctor and keep up on my prescriptions. When do I need to find new coverage?
Most health insurance runs through the current month. If you need new health insurance and are looking at plans at the Health Connector, the deadline is the 23rd of the month before you want coverage. So, if you’re looking for insurance starting Aug. 1, you need to enroll by July 23.
“It’s so important for people to understand the pay-it-ahead processes of health insurance, and know you need to enroll in advance for coverage,” says Karen Baumbach, executive director and lead navigator at Ecu-Health Care in North Adams. “Navigators and assisters can help make sure someone is picking a plan that includes the doctors and services they need to keep a continuation of care.”
How can I possibly afford health insurance by myself?
People who receive health insurance through their workplace typically have a large portion of their premiums paid by their employer. There is financial assistance provided through the Health Connector, which through the ConnectorCare program offers plans with low premiums and co-pays, and no deductible payments.
“We figure out income based on the current point in time, which means for people who just lost their jobs, they can tell us what their income currently is and quite possibly qualify for subsidized coverage,” says Alu. “So many people are happy when they get into ConnectorCare. The premiums are very low and as they find out, the out-of-pocket costs are also greatly reduced.”
I expect I’ll be back to work in the next few months. If I have other health insurance by then, can I drop it, or will there be a penalty?
“If people are getting coverage from the Health Connector, even for just a few months, that is exactly what the exchange is there for, to help fill in coverage gaps when people need it,” says Procaccini. “There’s no penalty if you drop Health Connector coverage if you get your job and benefits back, so there’s no downside to signing up.”
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