– Hi, I'm Susan Taylor with Scripps Health in San Diego, California. Tens of millions of peoplehave lost their jobs because of the COVID pandemic, which can also mean losing your employer provided health insurance. But there are optionsout there to help you get affordable healthcare coverage year round. Joining us to talk aboutthis is Shawn Forrester.
He is the corporate vice president of payer relations at Scripps Health. Thanks so much for being with us, Shawn. – Hi Susan, thank you for allowing me to talk to you today about this. – Sure. So what happensif you lose your job and your employerprovided health insurance during this pandemic? I mean, this is scary.
– It sure is. And health insurance maynot be the first thing you think about when you lose your job, but I do wanna stress how important it is. Especially during themiddle of a pandemic. There are some pretty critical deadlines that you'll need to be aware of. And I'll talk you throughthose in a few minutes. There could also be financial penalties.
If you don't sign up for health insurance during those deadlines. – What is COBRA and how does it work? – So COBRA is a federallaw that says employers must offer a continuation of the insurance that was offered to youthrough your employer. The way that would work is you have an initial 18-month period. And then at a later date,if you want to continue.
That plan even further, you can extend it for another 36 months. What you need to be criticallyaware of here though, is this is probably yourmost expensive option. So while you were employed and on the employer's health insurance, most likely your employer was absorbing most of the monthlypremium for that insurance. You very likely had some share in that.
So when you continue thatinsurance through COBRA, your employer may or may not continue to subsidize that cost. If you had an employer that chooses not to subsidize that cost, your monthly premium thatyou pay may quadruple. – But you could be payinghundreds or thousands of dollars more per month with coverage.- Absolutely. Then what about other options?.
To go on your spouse or domesticpartner's health insurance? – Yeah, so if your spouseor domestic partner has coverage through their employer, you can elect to go on that. That will not be freeof charge, of course, but that's an option for you. And if you're 26 years old or less, you could possibly go onyour parents' plan as well. – So how do you apply forCOBRA or Covered California?.
– COBRA is not an enrollment process. So what's gonna happen with COBRA is your employer is goingto give you a package that explains what isbeing offered to you. Generally, this is thesame coverage you have when you were employedthrough your employer. So the good part about thatis you're not gonna have to change health plans or physicians. – And this is really good.
If you're undergoing medicaltreatment like cancer treatment and you don't wanna change your doctors. – That's right, but it'snot your only option when you're concerned withcontinuation of coverage. In Covered California, you actually do have to apply for that. And the way you do that, is you go to their website, coveredca.com. And in Covered California,.
You may actually be eligiblefor financial assistance for their insurance options as well. In order to qualify forfinancial insurance, through Covered California, you will have to be between 138% and 400% of the federal poverty level. So to illustrate, ifyou're a single person, 138% of poverty level in,count year 2020 is $17,609. – If you're missing that per year, okay.
– Per year. If you're a family of four,that would be $36,156. Now in Covered California, as I said, it's up to 400% of thefederal poverty level in order to have federal subsidies. And to illustrate, there aremultiple levels tiers here, but if you're a single person it's 74,940, that would be the cutoff level in 2020. For a family of four, thatwould be an income of $154,500.
Now these are subject tochange in future years, but hopefully that helps illustrate. – And then, CoveredCalifornia, how does it work? How do you apply for it? – So Covered California isthe state-run public exchange for health insurance. What you would need todo is go to their website or you can call them, but most people chooseto go to their website.
And you will need toanswer several questions. To get started, go to coveredca.com,click on get coverage, then click on shop and compare, and then you're off and running. You'll be able to see the coststhat you would need to pay for all the various planoptions that Covered California has on its website. – And then if you wantaccess to Scripps doctors, what health plans on CoveredCalifornia should you look at?.
– Great question, Susan. So Scripps generally participatesin Covered California through two health plans. One of them is health netcalled community care HMO. That happens to be the leastexpensive plan option in 2020, and in 2021 on the bronze level. Another health plan that weparticipate in is Blue Shield, which is offering bothan HMO plan and a PPO. – And then can you applyfor this year round?.
– Again, no, you cannot. There is a 60-day windowin your qualifying period, but throughout the year,or once during the year, there's an open enrollmentperiod for Covered California. And that runs from October15 through January 31st of each year. Sometimes like in 2020,because of the pandemic, that period of time can be extended through a special enrollment period.
But you can't count onthat every single year. That's only in special events. – And then if you're over65 and you've lost your job, you can apply forMedicare anytime of year? – Absolutely, in fact, if you're over 65, chances are you alreadyhave Medicare part A. But when you lose your job, you'll need to sign upfor Medicare part B. You will have eight monthsin which to do that.
If you don't do thatin those eight months, and you don't gain other employment, then you may incur penalties. So you're gonna want to research that thoroughly directly with Medicare. Medicare has an openenrollment period every year. And that runs from October15 through December 7. And during that period, youcan change your health plans, you can change your coverage.
You're open to selectwhatever Medicare plan option is out there. – And then what about Medi-Cal? I mean that's for folks,it's low cost health coverage for folks who don't makea lot of money, right? – That's right, you haveto qualify for this. Your income level must be less than 138% of the federal poverty level. But the good news here isthere is no enrollment period.
You can sign up for thisanytime during the year. You can do that through, by going to the Health andHuman Services Department in San Diego in person. You could also sign up for thatthrough Covered California, coveredca.com, or justcall Covered California at 1-800-300-1506. We're happy to answer anyquestions that you have. We certainly wanna makesure that we can continue.
To see you in your time of need. So please let us help you. – Sean, thanks so much for explaining what is a very complicatedissue, that of insurance. – Thank you, Susan. – We appreciate it. Want more information about these affordablehealth insurance plans? Click on the link or goto scripps.org/videos.
Want more criticalinformation about your health? We take care of you from head to toe. Please subscribe to ourScripps Health YouTube channel and follow us on socialmedia at Scripps Health. I'm Susan Taylor, thanksso much for joining us. It's our mission atScripps to help you heal, enhance, even save your life. (upbeat music)