By Rose Chu:
As the unemployment rate climbs due to the coronovirus pandemic, it is important to know what options exist for continued healthcare coverage. Here are some insights from my experience as a health policy analyst, and a volunteer certified application counselor to enroll Virginians for the Federal Health Insurance Exchange and Medicaid.
The Affordable Care Act (“Obamacare”) is now 10 years old and has improved health insurance for everyone. Since 2010, there are no annual or lifetime limits, no denials of insurance or extra premiums because of pre-existing conditions, and children under the age of 26 can be included on a family policy.
If you lost health insurance through your job, you are eligible for a period of continued health insurance through your employer under a provision of federal law called COBRA, but the premiums are 102% of the total premiums. (For more information on COBRA, click here.)
Since the average employer pays 83% for single coverage and 71% for family coverage, paying 102% of the total premiums ($7,188 for single coverage and $20,576 for family coverage) is a lot more than paying the employee contribution alone.
However, you are eligible for a special enrollment on the Federal Health Insurance Exchange (set up by Obamacare) within 60 days of the loss of health insurance through your job.
If your expected 2020 family income is between 138% and 400% of the federal poverty level ($17,609 to $51,040 for a single person and $29,973 to $86,880 for a family of 3 persons), you may be eligible for premium tax credits that would lower your premiums.
In northern Virginia, 3 insurers participate in the Federal Health Insurance Exchange: Cigna, Kaiser and Carefirst or Anthem Blue Cross Blue Shield. You can check the premiums for your age and family here: https://www.healthcare.gov/see-plans/#/
You can also check whether your physicians and drugs are covered by the insurer.
When you are ready to apply, have information on your family members (social security numbers and birthdates), current and former employer, and estimated 2020 income and apply on healthcare.gov or call 1-800-318-2596 (interpreters for other languages are available).
Important to remember: If you purchase COBRA insurance but drop it, you are not eligible for a special enrollment and would have to wait until open enrollment (November 1 to December 15).
If your expected 2020 income is less than 138% of the Federal poverty level ($17,609 for a single person and $29,973 for a family of 3), you may be eligible for Medicaid.
You can apply for Medicaid and the Federal Health Insurance Exchange on healthcare.gov or apply for Medicaid on coverva.org or call 1-855-242-8282 Mon – Fri: 8:00 am to 7:00 pm and Sat: 9:00 am to 12:00 pm. If accepted, you would join a Medicaid managed care HMO plan (Aetna, Anthem Optima with Kaiser, United Healthcare, or Magellan).
Before Virginia expanded Medicaid, only single parents with children with income less than 38% of the federal poverty level with an asset limit of $2,000 (not including a car and household goods) could get Medicaid. Since January 2019, childless adults are eligible for Medicaid with family income less than 138% of the federal poverty level and no asset tests.
If you aren’t eligible for Medicaid or can’t afford health insurance through the Federal Exchange, there are community health centers in Fairfax County that provide primary care on a sliding scale based on your income, such as HealthWorks for Northern Virginia in Herndon and Reston (703 443-2000) and Neighborhood Health in several locations in Alexandria, Arlington and Fairfax County (703 535-5568). Inova’s Simplicity Health Clinics in Annandale, Alexandria and Sterling (571 665-6620) offer four weeks of primary care and basic behavioral health for $80 for those who aren’t eligible for Medicaid, don’t have a health plan through an employer or have a high deductible.
Rose Chu is a health policy analyst, and Vice Chair of the Fairfax County Health Care Advisory Board. She has been a Mason District Democratic Committee member since 1986 and is treasurer of the Virginia 8th Congressional District Democrats and the Democratic Asian Americans of Virginia.
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