What to Do When You Lose Your Health Insurance

A young woman looks at health insurance paperwork with frustration and confusion

Losing your job is stressful. Losing your health insurance on top of that is even worse. And whether you have health concerns now or want to safeguard yourself and family for the future, you might be worried about how to cover medical expenses if you’re out of work. Find out what to do when you lose your health insurance because you lost your job.

Ask About COBRA

COBRA is a health insurance continuation option that many employers offer. It allows you to voluntarily extend the health coverage you have under your former employer’s plan. If you qualify for COBRA, you must be given the option to extend your coverage up to 18 or 36 months, depending on what event qualified you for COBRA.

However, your employer does not have to continue
contributing to cover the premiums of this plan as they did when you were
employed. If they elect to not offer contributions to the premium, COBRA
coverage can be fairly expensive.

Check the Health Care Marketplace

Job loss that causes you to lose employer-sponsored or provided health insurance counts as a qualifying event. That means you’re eligible for a special enrollment period.

Normally, you can only sign up for insurance plans through
the health care marketplaces during open enrollment periods, which typically run
from November to January. Exact dates for enrollment depend on the state.

Special enrollment periods occur for people who have a
qualifying event, such as a change in marriage status, a death in the family or
job loss. You qualify for this special period whether you were fired, laid off
or quit your job.

You must apply within 60 days of losing your insurance coverage. If your employee gives you notice and you know you’ll be losing your insurance, you can apply proactively up to 60 days before that happens.

Purchase Short-Term Coverage

Short-term insurance policies are meant to bridge the gap when you’re between jobs. Not all states allow for short-term insurance—eleven states currently prohibit their sale. But, depending on your state, short-term insurance could cover you for up to 364 days. These aren’t qualified plans under the ACA, which means they don’t offer all the benefits that the ACA requires by law. Typically, these are major medical plans meant to help cover the costs of a catastrophic illness or accident and not routine health care.

Make
sure you understand what benefits are included and how the plan works if you
opt for short-term coverage.

See If You
Qualify for Medicaid

A man holds the hand of a young child while they walk down the street.

If you have lost your job, that probably means your income has been reduced. That could mean that you’re eligible for Medicaid or the Children’s Health Insurance Program (CHIP). The income requirements vary by state, but you can find out more about eligibility from the Department of Health and Human Services.

You
can apply for Medicaid and CHIP at any time, but remember that you can lose
your Medicaid benefits if your income changes. Have a plan in place to budget
for health insurance if you get a job that doesn’t offer benefits or has a
waiting period before benefits start.

Go Without Health Insurance

You can choose to go without health insurance until you find another job or until open enrollment happens again. This can be a risky move because a health emergency or accident could lead to mounting medical expenses that leave you in serious debt.

But if you’re healthy and think there’s a good chance you’ll get a new job with coverage soon, you might decide to take the gamble. If you do, it’s a good idea to set aside some money in savings to help cover the cost of doctor’s visits or other necessary medical care should the need arise. For example, during COVD-19, you might use your stimulus check for this purpose.

You Have Options

Losing your job and your health insurance is scary, but you’re not alone. Credit.com has resources to help you through. Check out our additional resources below—and if you need more help, you can reach out to tipswithtiff@credit.com for help from Credit Tips with Tiff.

  • How to Find an Affordable Health Insurance Plan
  • Job Opportunities During COVID-19
  • Credit Options to Help Manage Health Care Costs

The post What to Do When You Lose Your Health Insurance appeared first on Credit.com.

Source: credit.com

A Guide to Coinsurance and Copays

You often pay your copay when you check in for a visit.

Having health insurance makes it possible to receive medical care while only paying a fraction of that care’s true cost. Insurance doesn’t cover everything, however. Some of the cost of your care is still up to you to pay, and that cost comes in two primary forms: copays and coinsurance.

What Is a Copay?

A copay is a flat amount of money that you’re responsible for paying for a health care service. Copays typically apply for things like a doctor’s appointment, prescription drug or medical test. The amount of your copay is dependent on your specific health insurance plan.

You can typically expect to pay your copay when you check in for your service, be it an annual physical, dental cleaning or blood test. Copays are typically lower amounts ranging from $10 for something like a generic drug prescription to around $65 for a visit to a medical specialist.

Depending on your insurance plan, copays may not take effect until after you reach your deductible. Your deductible is the amount of money you must pay out-of-pocket before your insurance provider starts to pitch in. Deductibles reset at the beginning of every year.

When you are reviewing your plan information and you see the phrase “after deductible” or “deductible applies” in reference to your copays, that’s an indication that the copay is only in place once you meet your deductible. On the other hand, if you see “deductible waived,” that’s a sign that your copay is in place from the beginning. It may go without saying, but the latter situation is vastly preferable to you.

What Is Coinsurance?

Coinsurance is another method of splitting the cost of medical coverage with your insurance plan. A coinsurance is a percentage of the cost of services. You pay the percentage, and your insurance company foots the rest of the bill. So, if you have a $8,000 medical bill and a 20% coinsurance, you would be on the hook for $1,600.

Coinsurance typically only comes into play after you hit your deductible. Further, you may have differing coinsurance percentages for the same services depending on your provider network. If you have a preferred provider organization (PPO) plan, your coinsurance could be a higher percentage for providers outside your network than it is for providers in your network.

Similarly, your coinsurance may not apply to providers outside your network if you have a health maintenance organization (HMO) plan or an exclusive provider organization (EPO) plan. That’s because these plans typically don’t provide any out-of-network coverage.

Copay vs. Coinsurance

You likely pay a copay when you visit the doctor.

Copay and coinsurance are very similar terms. They both have to do with portions of the cost of your health care that’s under your responsibility. Because of that, and their similar names, it’s easy to confuse the two. There are a couple of important distinctions to keep in mind, however.

The most notable difference between copays and coinsurance is that copays are always a flat amount and coinsurance is always a percentage of the cost of the service. Another difference is that some copays can be in place before you hit your deductible, depending on the specifics of your plan. With coinsurance, you have to hit your deductible first.

Bottom Line

copays are fixed amounts, while coinsurance is a percentage.

If you’re choosing between health insurance plans, make sure to examine the provided copays and coinsurance for each option. While they may not be the most important factor to consider, a high copay can be quite a pain, especially over the course of years of appointments and procedures.

Tips for Staying on Top of Medical Expenses

  • One of the best ways to stay ahead of surprise medical expenses is to have an emergency fund in place for just such a situation. If you can manage it, have three to six months worth of expenses stashed away in a high-yield savings account. That way, if you’re dealing with medical bills or have to step away from work, you’ll have a bit of a cushion.
  • If you’re not sure how an unexpected medical expenses would fit into your finances, consider working with a financial advisor to develop a financial plan. Finding the right financial advisor that fits your needs doesn’t have to be hard. SmartAsset’s free tool matches you with financial advisors in your area in 5 minutes. If you’re ready to be matched with local advisors that will help you achieve your financial goals, get started now.

Photo Credit: ©iStock.com/DuxX, Â©iStock.com/SARINYAPINNGAM, Â©iStock.com/Aja Koska

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Questions to Ask When Shopping for Health Insurance

Whether you are acquiring it through your employer or on your own, shopping for health insurance coverage is a task that many adults will be faced with at some point. Health coverage is not a one-size-fits all amenity, and it comes in many forms such as Point of Service (POS), Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs) and more. 

Buying health insurance is a big commitment, so do the research and look over all your options before making any hasty decisions. Technical information about different health insurance policies can be overwhelming, which is why seeking the help of a licensed insurance agent or a health insurance broker might be your best bet. In the following sections we will discuss ways you can prepare to meet with a health insurance agent as well as what questions to ask. 

How to prepare to meet with a health insurance agent 

Health insurance exists to protect us financially when we get sick or injured, which is why it’s so important for you to look at plans that fit the unique needs of you and your family. Whether you are an employer shopping for insurance plans for your employees, or just an individual browsing your options, choosing a caring agent who takes their job seriously is key to finding the right plan. To start, you will want to work with an insurance agent who is experienced, knowledgeable and trustworthy.

Finding the right agent to work with isn’t the only important piece of the puzzle, you’ll also want to do your part as well. Coming prepared to the appointment will help things run more smoothly and will ensure that you to ask the right questions. 

Before meeting with the insurance agent, make sure that you:

  • Know how much you are willing to pay: Before your appointment with an insurance agency, you should consider how much risk you want to assume for yourself versus how much risk you want the insurance company to assume for you. In other words, would you rather make higher monthly insurance payments and have a lower deductible or would you rather pay a lower monthly insurance payment and have a higher deductible? If you’re okay with paying a hefty deductible during a medical crisis, then you might consider choosing a plan with a lower monthly payment. On the other hand, someone who needs more consistent medical care might opt for a plan with a lower deductible. 
  • Research the insurance agency that you will be doing business with: Ask friends and loved ones for feedback on the agencies they’ve worked with and find out how their experience was. If you are an employer, do some research to see what agencies other companies do business with. The important thing is that you choose an agency that you trust. 
  • Know what to bring with you: In order for the agent to help you the best they can, they will need to know as much information as possible about yours and your family’s medical history. The agent will want to know about any of yours or your family’s medical conditions and personal habits such as drinking, smoking, diet, etc. Call in advance and find out exactly what you need to bring. Be truthful and thorough so that your agent can find the best health insurance policy for you. 
  • Make a list of the questions that you will want to ask: It’s easy to get overwhelmed during these appointments. Writing down your questions will not only help you to be more organized, but it will also lower your chances of forgetting to bring up important topics.  

Questions to ask your health insurance agents

Before meeting with a licensed insurance agent, you should write down a list of questions that you want to have answered during your appointment. Here are some questions you should be asking your agent about your insurance before buying:

    • How much will it cost? This is probably the most dreaded part of the conversation, but it has to be discussed! The overall cost of your health insurance policy will depend on your premium, deductible and out-of-pocket-max. When browsing through plans, you’ll want to take notes on how much these three items will cost up front, because each plan varies in rates.
      • Premium: Health insurance premiums are rates that you will pay every month in order to secure your coverage. The initial payment you receive will be a premium, and will continue monthly. 
      • Deductible: If your plan has a deductible of $2,000, then that means you will be responsible for paying the first $2,000 of health care before your plan begins covering certain costs. Once you pay your deductible, you’ll pay significantly less for your health care. 
  • Out-of-pocket max: This is basically the maximum amount of money that you will ever have to be responsible for paying while covered—as long as you stay in-network, that is. Let’s say your out-of-pocket max is $5,000, but you end up needing surgery that costs $30,000. You would only have to worry about paying $5,000. Additionally, if you’ve already reached your $2,000 deductible, then you would only have to pay $3,000. The purpose of an out-of-pocket max is to protect you from having to pay extremely expensive bills, but remember—the surgery would need to happen at a medical facility that is in-network.  
  • Is my current doctor covered? If you’re already receiving health care, you’ll want to know if your current doctor is a part of any prospective insurance company’s network of health providers. This information should be fairly simple to find out but could be an important factor in your decision. If you are currently taking any medications, you’ll also want to ask your agent to check the formulary to see if your prescriptions are covered.
  • Who do I contact when I have questions? It’s important to find out if your prospective health insurance company has a customer service team you can call or message when you need to inquire about bills, claims, copays or anything else insurance-related. Does the company have a separate phone number to call when you want help finding a health care provider? Is this customer service line automated or will you be speaking to an actual insurance representative? These questions are important to determine what kind of support is available long after you’ve signed a contract. 

What happens during an emergency? When going to see a doctor for a normal visit, you have time to plan and make sure that the doctor is in-network. However, during an emergency, we may not have the same luxury. It’s possible that in a case where you need dire medical attention, the closest health care provider may not be in-network. You should ask about your prospective company’s policy on emergencies and what the standard routine consists of.

Questions to Ask When Shopping for Health Insurance is a post from Pocket Your Dollars.

Source: pocketyourdollars.com

A September State of Mind

Hi friends. So sorry to go completely MIA on you. Between attempting online school with a five-year-old, much of California burning to the ground, and the general state total chaos in which we find ourselves, getting to the computer for any length of time has been a bit of challenge, to put it mildly. And then I blinked and summer is officially over.

But I had to finally get on here as I have big news for you!

They say you shouldn’t make major life decisions during times of extreme stress, right? Well, we decided to throw all caution to the wind and instead have purchased a coastal cottage in Washington State! Apparently a global pandemic, homeschooling a kindergartner and the most consequential presidential election of our lifetime wasn’t enough to keep me busy.

coastal cottage mood board on Apartment 34

In all seriousness, if the past seven months of Covid have taught us anything, it’s the importance of friends and family and so we decided to create a gathering place that can bring together those we love most for years to come. Nestled within the myriad of inlets and islands that dot the Puget Sound north of Seattle, the cottage enjoys sweeping views of the Olympic mountains and Hood Canal. I consider it my official respite from the impending doom. Sadly it looks nothing like the inspiration images I’ve collected here.

Instead, it is going to take a LOT of work to get our little coastal cottage visitor ready – and in a very short period of time. Over the coming weeks, I plan to take you along on the entire design journey. I will be sharing everything with you – from the cottage’s current state, to all of my design inspiration and through the remodel process. If all goes according to plan, I’ll share a major before and after reveal in time to spend the holiday season with our family rather than more than 800 miles away.

coastal cottage mood board on Apartment 34

Trust me, we’re going to have plenty to discuss, as I have to pick an entire household’s worth of things – from paint colors and kitchen cabinets down to dishware, bedding and everything in between. No design decision will be left unturned. It’s both exhilarating and incredibly daunting. These mood boards are just part my first ideation session for my dream vibe.

I’m hopeful sharing this process with you will offer you some fresh design ideas and positive inspiration as we all hunker down to weather what will undoubtedly be a stormy fall – be it literally or just politically. It’s been a rather dark year and I feel like this might be a way to share a little bit of light. I know I am very happy for the creative distraction. I hope you are too.

I can’t wait to share more very soon!

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Source: apartment34.com