The Post asked researchers, health insurance brokers and patient advocates for advice. Here are their recommendations.
Take advantage of your health insurance before it runs out
As soon as you receive notification about loss of employment, your first step should be to contact your human resources department and ask when your health insurance will be terminated. It is essential information so you can schedule medical appointments and make a plan to obtain new coverage before any deadlines pass, experts said.
Catch up on your medical appointments
In the stress and disappointment of job loss, you may be focused on finding new employment. But you also should prioritize getting the most out of your current medical policy. If you are covered through the end of the month, try to schedule bloodwork, imaging tests and checkups with your primary care doctor, dentist and any specialists you see for chronic conditions. Try to book an appointment with your therapist or other mental health professional, particularly since this can be a stressful time. If a doctor does not have any availability before your health insurance is terminated, explain your situation and ask to be put on a cancellation list.
Get new glasses or contacts if you need them. Request advance refills for all prescription medications and ask about a three-month supply vs. a one-month supply. Do all the same things for every family member on your policy.
Understand FSA and HSA rules
If you have been putting money into a Flexible Spending Account, or FSA, be aware there is a “use it or lose it” policy that requires you to use the money within a certain amount of time, and you can use it only for expenses incurred during your employment, said Sarah Michalczuk, founder and chief executive of Predictabill, a tool to help consumers compare health insurance options. Find receipts for drugstore purchases such as pain relievers, cold medicines and tampons, glasses, contact lenses, skin-care products and health technology, and get reimbursed from your FSA.
There are no stipulations on when you must spend the money in your Health Savings Account, or HSA. There are rules, however, regarding when you put money into it, Michalczuk said. You can contribute to your HSA only while you are on a qualifying High-Deductible Health Plan (HDHP), she said.
Your employer should be able to provide a list of qualifying expenses for your FSA and HSA funds.
Be strategic when choosing a new health insurance plan
When shopping for new insurance plans, experts said, you will want to know whether picking one insurance plan over another will force you to change medical providers. It’s a good idea to call your doctors to find out whether they accept the new plans you are considering.
Consider keeping your employer-based insurance if you’ve met deductibles
Keeping your employer-based insurance can be expensive, but it may make sense if you have already met your deductible or, better yet, reached your out-of-pocket maximum, particularly if you have an upcoming surgery or other medical procedure. Switching to a new plan would reset your deductible, experts said.
People who lose their jobs are eligible to keep their existing employer-based benefits under the Consolidated Omnibus Budget Reconciliation Act, or COBRA, which applies to companies of a certain size.
Most employers, particularly larger companies, typically subsidize about 80 percent of the total premium, meaning that you will go from paying about 20 percent to paying about 102 percent of the cost, once you factor in the 2 percent administrative fee, said Gerald Kominski, a senior fellow at the UCLA Center for Health Policy Research. “That’s a big financial hit,” he said.
You have 60 days from the date the notice is sent to you to opt in to COBRA, and it must be available to you for 18 months, though in certain circumstances it may last 36 months.
Consider Affordable Care Act marketplace plans
Job loss is a qualifying event for enrollment in insurance plans under the Affordable Care Act (ACA) even if it is not an open enrollment period. These insurance marketplaces are a place to shop for plans, which may be subsidized by the government depending on your household income.
There are four levels of coverage — bronze, silver, gold and platinum. Lower-tiered plans typically have lower premiums but higher out-of-pocket costs. Higher-tiered plans usually have higher premiums but lower out-of-pocket costs.
Deb Gordon, co-director of the Alliance of Professional Health Advocates, said silver plans are “not the Cadillacs” of health insurance coverage, but because of possible cost-sharing subsidies, they are often considered the best value. High-quality employer-based health insurance plans are most equivalent to gold and platinum marketplace plans, experts explained.
When choosing a plan, Gordon urged people to factor in out-of-pocket maximums “because that is a lever that insurers use in plan design.” She said some plans may have lower deductibles, but the out-of-pocket maximum may be $8,000, for example, meaning you will be responsible for out-of-pocket costs until you hit it. “That’s just another way you could estimate your total financial exposure,” she said.
You have 60 days after losing your health coverage to take advantage of the special enrollment period.
You may be eligible for Medicare or Medicaid
Medicare and Medicaid are government-sponsored programs that are good options for people who meet the requirements.
If you are retirement age — 65 or older — Medicare is probably your best bet.
If your total household income is low enough, you may qualify for Medicaid, which is most often free. Depending on where you live, it is possible that fewer doctors will accept Medicaid (as well as certain marketplace plans), but “there will be major hospitals in-network if your main concern is coverage in cases of emergencies,” Michalczuk wrote in an email.
If you are married, your spouse’s plan may be a good option
If you are eligible for your spouse’s employer-based health insurance plan and the out-of-pocket cost for family coverage is less than about 9 percent of your household income, you will not be eligible for marketplace subsidies, which is an incentive to join your spouse’s plan, Kominski said.
“That’s always, in some sense, the lowest-cost option and, in fact, may be the preferred option,” he said.
One caveat is some employers may charge a fee to add a spouse to the plan, Michalczuk noted.
Check to see whether your spouse’s coverage allows you to opt in and how long you have to do it.
An individual policy is also an option — but it’s expensive
Going outside the marketplace for private health insurance plans can be costly.
High-income individuals who were not satisfied with their employer-based benefits and do not want to continue through COBRA, or those who remain unemployed past the 18-month point, for example, may decide to consider a private insurance plan, experts said.
In such cases, consulting a patient advocate or health insurance broker may be a good idea to help you understand which options are available to you and are the best fit.
Find ways to cut medical costs
If you need to see your doctors before you secure new coverage, contact them and explain your circumstances. Medical providers may offer financial assistance or payment plans, and mental health providers sometimes offer a sliding scale for established clients, experts explained.
For prescription medications, drug discount apps and websites such as GoodRx can be a great place to find medications at a reduced cost. Some online pharmacies offer them for a lower price, too. There are also drug assistance programs and co-pay assistance programs for which you may be eligible, said Caitlin Donovan, senior director of the Patient Advocate Foundation.
Drug manufacturers, government programs and nonprofit organizations may offer prescription medications at a reduced or no cost for low-income individuals without adequate insurance.
Similarly, co-pay assistance programs cover part or all of the co-pay for certain medications.
Utilize other resources to free up dollars for medical care
As soon as you lose your job, apply for unemployment insurance. If you are eligible, you will receive financial assistance that you can put toward groceries or child care, freeing up funds for medical expenses.
You can also check into assistance programs through your church or community organizations, including animal shelters, which may be able to supply food, for example, for your pets, during difficult times, Donovan said.
“Being uninsured can be a full-time job. There’s a lot of paperwork, there’s a lot of deadlines, and at the same time, you’re probably looking for a job, too,” she said. “So it’s stressful.” But, she added, the important thing is to “try to remember that this is hopefully a short-term problem.”
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