It’s no secret that healthcare is expensive, and many Americans struggle to afford health insurance. However, going without health insurance can be a risky decision, as medical emergencies and unexpected illnesses can happen at any moment. If you’re in a situation where you need health insurance now, whether due to job loss or other circumstances, there are several options available to you. In this article, we’ll go over everything you need to know about getting health insurance quickly and affordable.
Why You Need Health Insurance
Health insurance is essential for protecting your physical and financial well-being. Without insurance, you could face expensive medical bills that could leave you in debt. Additionally, health insurance can provide you with access to preventative care, such as routine checkups and screenings, which can help detect potentially serious health issues early on. Health insurance can also cover the cost of prescription drugs, surgeries, and other medical treatments that you may need to maintain your health.
While the cost of health insurance can be high, the cost of not having insurance can be even higher. One medical emergency could result in hospital bills totalling tens of thousands of dollars. In fact, medical debt is the leading cause of bankruptcy in the United States.
What Are Your Options?
If you need health insurance now, there are several options available to you:
Option |
Description |
|---|---|
Cobra |
If you recently lost your job or had a reduction in hours, you may be eligible for COBRA coverage. This allows you to keep your employer-sponsored health insurance for a limited time. |
ACA Marketplace |
The Affordable Care Act (ACA) created state-run health insurance marketplaces where individuals can purchase health insurance. Open enrollment is typically in the fall, but you may qualify for a special enrollment period if you’ve experienced a qualifying life event, such as losing your job. |
Short-Term Health Insurance |
Short-term health insurance plans are designed to bridge the gap between coverage. These plans usually last from one to six months and can be purchased at any time of year. However, they may not cover all the benefits of a traditional health insurance plan. |
Medicaid |
Medicaid is a government-funded program that provides health insurance to low-income individuals and families. Eligibility requirements vary by state. |
COBRA Coverage
What is COBRA?
COBRA, or the Consolidated Omnibus Budget Reconciliation Act, is a federal law that allows employees to continue their employer-sponsored health insurance for a limited time after leaving their job or experiencing a reduction in hours. COBRA coverage is typically more expensive than other options, but it can be a good choice if you need to maintain the same level of coverage you had before losing your job.
Who is Eligible for COBRA?
To be eligible for COBRA coverage, you must have been enrolled in your employer-sponsored health insurance plan and lost coverage due to one of the following:
- Losing your job (for reasons other than gross misconduct)
- Experiencing a reduction in hours that made you ineligible for coverage
- Getting divorced or legally separated from your spouse who sponsored your health insurance plan
- The death of the employee
You must also meet the following requirements:
- You must have been enrolled in the employer-sponsored plan for at least one day before losing coverage
- You must submit your COBRA election within 60 days of losing your coverage
- You must pay the full cost of COBRA coverage, including the portion your employer previously paid
How Long Does COBRA Coverage Last?
COBRA coverage typically lasts for 18 months, although it can be extended to up to 36 months in certain circumstances, such as if the employee becomes disabled. However, it’s important to note that COBRA coverage is temporary, and you will need to find alternative coverage once it expires.
Affordable Care Act Marketplace
What is the ACA Marketplace?
The Affordable Care Act (ACA) created state-run health insurance marketplaces where individuals can purchase health insurance. Plans are offered by private insurance companies, but they must meet certain requirements set by the ACA. The Marketplace offers a variety of plan options and pricing based on your income and other factors.
When Can You Enroll in Health Insurance Through the Marketplace?
Open enrollment for health insurance through the Marketplace typically occurs in the fall, but you may qualify for a special enrollment period if you’ve experienced a qualifying life event, such as losing your job. Special enrollment periods typically last for 60 days after the qualifying event.
What Are the Qualifying Life Events?
Qualifying life events include:
- Losing your job-based coverage
- Getting married or divorced
- Having a baby or adopting a child
- Moving to a new area that offers different health plan options
- Becoming ineligible for Medicaid or CHIP
What Kinds of Plans Are Offered on the Marketplace?
The Marketplace offers several different plan types, including:
- Health maintenance organization (HMO)
- Preferred provider organization (PPO)
- Exclusive provider organization (EPO)
- Point of service (POS)
What are the Costs of Plans on the Marketplace?
The cost of health insurance plans on the Marketplace varies based on several factors, including your income, family size, and the type of plan you choose. However, the Marketplace offers subsidies to help make coverage more affordable for low-income individuals and families. Additionally, some plans offer cost-sharing reductions that can lower your out-of-pocket expenses.
Short-Term Health Insurance
What is Short-Term Health Insurance?
Short-term health insurance plans are designed to bridge the gap between coverage. They typically last from one to six months and can be purchased at any time of year. However, they may not cover all the benefits of a traditional health insurance plan, and they are not required to meet the same ACA requirements as Marketplace plans.
What Do Short-Term Health Insurance Plans Cover?
Short-term health insurance plans may cover some or all of the following:
- Doctor visits
- Urgent care visits
- Emergency room visits
- Lab tests
- Prescription drugs
What Are the Costs of Short-Term Health Insurance Plans?
The cost of short-term health insurance plans varies depending on several factors, including your age, location, and the level of coverage you choose. However, short-term health insurance plans are typically less expensive than Marketplace plans.
Medicaid
What is Medicaid?
Medicaid is a government-funded program that provides health insurance to low-income individuals and families. Eligibility requirements vary by state, but generally, you must have an income that falls below a certain threshold to qualify.
What Does Medicaid Cover?
Medicaid covers a wide range of healthcare services, including:
- Doctor visits
- Inpatient hospital care
- Outpatient hospital care
- Lab tests
- X-rays
- Prescription drugs
What Are the Eligibility Requirements for Medicaid?
Eligibility requirements for Medicaid vary by state, but generally, you must have an income that falls below a certain threshold to qualify. Additionally, you must be a U.S. citizen or a legal permanent resident, and you must meet other criteria related to your age, disability status, and other factors.
How Do You Apply for Medicaid?
To apply for Medicaid, you will need to fill out an application with your state’s Medicaid agency. You can typically apply online, by mail, or in person at a local Medicaid office.
Conclusion
If you need health insurance now, there are several options available to you, including COBRA coverage, the ACA Marketplace, short-term health insurance, and Medicaid. Each option has its own advantages and disadvantages, so it’s important to carefully consider your needs and budget when choosing a plan. With the right coverage, you can protect both your physical and financial well-being.
FAQ
What is the best option for affordable health insurance if I need it now?
The best option for affordable health insurance if you need it now depends on your specific circumstances, such as your income, family size, and health needs. However, Medicaid and short-term health insurance plans are typically the most affordable options.
Can I enroll in health insurance through the ACA Marketplace outside of open enrollment?
You may be able to enroll in health insurance through the ACA Marketplace outside of open enrollment if you’ve experienced a qualifying life event, such as losing your job or getting divorced.
What is the difference between an HMO and a PPO?
An HMO, or health maintenance organization, typically requires you to choose a primary care physician and get referrals to see specialists. A PPO, or preferred provider organization, allows you to see any healthcare provider in the plan’s network without a referral, but you may pay higher out-of-pocket costs for out-of-network care.
Can I Get Health Insurance if I Have a Pre-Existing Condition?
Yes, under the Affordable Care Act, insurance companies cannot deny coverage or charge higher premiums to individuals with pre-existing conditions.