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Health insurance options for those affected by job loss

Date: 04/14/20

As COVID-19 Affects Job Situations, Some Oregon Residents Must Look for New Health Coverage

Health insurance options are available for people whose health coverage was affected by job loss

April 14, (Eugene, OR) – More than 6.6 million people filed for unemployment benefits last week – breaking a record for the U.S. that was set the previous week.

For many of these Americans, however, losing a job doesn’t just create worry about providing for their families. It also raises concerns about protecting their health during a pandemic. About half of all Americans get their health insurance through their employer, so for many people, being newly unemployed brings with it uncertainty about how to navigate their health coverage options.

It’s important for Oregonian’s who have lost their jobs to know that the Affordable Care Act includes a provision that gives people 60 days to enroll in health care after a qualifying life event, such as job loss.

There are a variety of affordable health coverage options, including Medicaid and the Oregon Health Insurance Marketplace through the Affordable Care Act (ACA). Each program has unique characteristics and requirements as outlined below:

  • Oregon Health Plan/Medicaid offers free or low-cost health insurance coverage for lower income residents and the unemployed:
    • In Oregon, Oregon Health Plan (OHP) coverage includes OHP Plus, OHP Plus Supplemental, OHP with Limited Drug, CAWEM and Qualified Medical Beneficiary.
    • Residents may qualify if their current income is up to [100 percent/138 percent] of the federal poverty level, which is $1,467 per month for an individual and $3,013 per month for a family of four. Note: CARES Act supplementary unemployment insurance benefits, which can increase unemployment benefits by $600 per week, do not impact eligibility for Medicaid programs.
    • Enrollment is offered year-round, and healthcare services provided up to three months prior to enrollment can be covered retroactively.
    • To enroll in the Oregon Health Plan visit: www.oregon.gov/OHA or call 800-699-9075
  • Health Insurance Marketplace is for anyone who doesn’t receive employer-provided coverage, and it allows people to choose from multiple health insurance plans to find the right coverage:
    • Enrollment is available during a special enrollment period (SEP). Once a person experiences a qualifying life event such as job loss, they have 60 days to enroll.
    • Financial assistance is available for Marketplace coverage if a person’s expected 2020 income will be 100%-400% of the federal poverty level, which is $12,490-$49,960 for an individual and $25,750-$103,000 for a family of four.
    • To be eligible for coverage, a person much live in the United States, be a U.S. citizen or national, and can’t be incarcerated. Healthcare.gov has more details on eligibility.
    • To find out what qualifies for SEP and shop for ACA coverage, visit Healthcare.gov or call 1-800-318-2596 (TTY: 1-855-889-4325).

Both Medicaid and Marketplace provide an alternative that’s often more affordable than COBRA, the health insurance program that allows people to continue their employer-provided coverage if they have lost their job, and it’s important to understand the differences. While COBRA maintains a person’s existing coverage, they will pay 100 percent of the cost plus an additional 2% in administrative costs. Subsidies to reduce costs are not available through COBRA, and coverage can last between 18 to 36 months, depending on the circumstances of job loss. However, it will eventually expire, and a person may be required to find new coverage, either through employment, Medicaid, or the ACA Marketplace.

“The impacts of the COVID-19 public health crisis are far reaching. It’s not only affecting people’s health, but also their employment situation and ability to access healthcare,” said Karen Sawyer “At Trillium Community Health Plan, we want to support our communities in making informed decisions about their health coverage options, so they can access the care they need.”

Trillium is available to help people navigate health insurance options during this public health crisis. For information about COVID-19, please visit the Center for Disease Control and Prevention’s (CDC) website. For any questions about health insurance coverage options, please visit www.trilliumohp.com or call 877) 600-5472

About Trillium Community Health Plan

Trillium Community Health Plan currently serves approximately 35,000 Oregon Health Plan members through the CCO model, which began in 2012. Trillium is a recognized leader for outstanding coordination of care. It was first awarded a contract with the state of Oregon to help manage care for the Oregon Health Plan in 1999.  Trillium partners with an extensive group of providers to improve care and access to services in Lane and Western Linn and Douglas Counties.