What to do if you lose your health insurance
Health insurance is confusing, so we've outlined a few options should you suddenly lose coverage
For something so vital to life in the United States, the world of health insurance is unnecessarily confusing. So if you're feeling lost after suddenly losing your job-provided coverage, don't worry — we've outlined a few options to get you out of uninsured limbo and back to the doctor's office faster than you can say "deductible."
The first steps
As soon as you're let go or fired, The Washington Post recommends immediately contacting your HR department to ask when your current insurance plan will be terminated. Ideally, you'll have enough time to schedule and attend any urgent or routine medical appointments before that coverage lapses. If your doctor does not have availability before then, "explain your situation and ask to be put on a cancellation list." Request refills for prescription meds and get new contacts if needed. Do the same "for every family member on your policy."
Option 1: Enroll in COBRA
COBRA, which stands for Consolidated Omnibus Budget Reconciliation Act, is a 1985 federal law that allows those who lose their job to continue their current employer-sponsored health coverage for a limited time. The biggest downside? It can be "significantly more expensive than what you paid under your employer's plan" because you're paying 100% of the cost, said Cigna, an insurance provider. In other words, you're paying much more for the same coverage, since your employer is no longer covering their portion of the bill.
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Option 2: Buy an individual health plan through a state or federal marketplace
Thanks to the Affordable Care Act, those newly out-of-work can shop for an individual health plan through a broker or insurance marketplace up to 60 days after losing their job-provided coverage. And depending on your projected yearly income, you might also qualify for subsidies to help offset the cost of your new individual plan. "The subsidies are a tax credit," explained Verywell Health. "But instead of having to wait and claim it on your tax return, it can be paid directly to your new insurance company each month in order to lower the amount you have to pay each month for coverage." To purchase an individual plan, visit your state's online marketplace. If there's no marketplace in your state, visit HealthCare.gov.
Option 3: Buy an off-exchange plan
Per HealthInsurance.org, an off-exchange or off-marketplace plan "is a health insurance policy that is purchased directly from an insurance company or through an agent or broker" and falls outside of the ACA-created insurance marketplace. But take note: "Premium subsidies (premium tax credits) and cost-sharing reductions (cost-sharing subsidies) are only available if you shop in the exchange," meaning an off-exchange plan is "generally only a reasonable option" for people who know they wouldn't qualify for any cost assistance, according to VeryWell Health.
Option 4: Check if you qualify for Medicaid or Medicare
If you're older than 65, you likely qualify for coverage under Medicare. But if "your total household income is low enough, you may qualify for Medicaid, which is most often free," the Post explained. As of March 2023, 40 states had expanded Medicaid coverage to allow adults to qualify by their income alone, which must be 138% below the Federal Poverty Level. Otherwise, you can qualify "based on income, household size, disability, family status and other factors," per HealthCare.Gov.
Option 5: Find a short-term plan
If you're looking for coverage you can easily cancel without penalty, or something to tide you over in between jobs (ideally just a few months), a short-term plan could be worth exploring. Such insurance typically provides little help with preventative care, doctor visits, urgent care, emergency care and possibly prescriptions during temporary gaps in coverage, per Cigna. It is not, however, required to meet certain standards or mandates outlined by the ACA and typically comprises "significantly higher deductibles" than traditional insurance plans. There's also no coverage for preexisting conditions.
Option 6: Explore ways to cut medical costs
Though it doesn't entirely solve the problem of being uninsured, there might be ways to access the medicine and treatment you need without paying a hefty price. For reproductive, gynecological or sexual-health care for both women and men, uninsured patients may qualify for reduced or no-cost help at Planned Parenthood. And for discount medications, those in need might try a website like GoodRx or Mark Cuban's Cost Plus Drugs. "There are also drug assistance programs and co-pay assistance programs for which you may be eligible," the Post reported, per Caitlin Donovan, a senior director at the Patient Advocate Foundation.
Apply immediately for unemployment benefits, which should help free up some cash for emergency health care expenses, the Post continued. And if you can, lean on your community. A site like FindHelp.org can help you quickly and easily locate low-cost health, food, housing and legal services in your area.
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Brigid Kennedy worked at The Week from 2021 to 2023 as a staff writer, junior editor and then story editor, with an interest in U.S. politics, the economy and the music industry.
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