You may be wondering how you can get health insurance. With so many options out there, it can be difficult to determine which one is best for you. We’ll cover the four most common ways to get health insurance: through your job, COBRA, Medicare/Medicaid and individual providers.
You can get health insurance in the following ways:
You can get health insurance in the following ways:
- Through your job. Many people have access to free or low-cost health insurance through their employer. If you work for a company that offers this benefit, it’s worth exploring how much it’ll cost you out of pocket and what kind of coverage you receive.
- Through COBRA. If your employer offers a group plan, but you leave the company before being eligible for Medicare or Medicaid, you may be able to continue receiving coverage through a federal law called COBRA (Consolidated Omnibus Budget Reconciliation Act). This law allows former employees to continue paying into the same plan as long as they still live within the area covered by that plan’s network of providers. However, there are some restrictions on who qualifies under this provision: Those who’ve been terminated involuntarily are not eligible; nor are those who’ve become disabled or medically uninsurable since leaving their job.
- Through Medicare/Medicaid after 65 years old – Another option is to enroll in Medicaid if your income falls below 138% of FPL ($1664 per month) or participate in Medicare after reaching 65 years old and enrolling before turning 65 years old
1. Through your job
If you’re employed, your employer should offer health insurance. This is an important benefit and typically comes with the job. However, it’s not guaranteed that you’ll have access to this type of coverage—you’ll need to choose whether to accept or decline.
Check with your HR representative to see if your company offers health insurance benefits and if there are specific forms or paperwork that need to be completed in order for them to be offered at work. If there aren’t any forms listed on the employee portal or intranet website, you may want to contact the human resources department directly so they can assist you in completing the appropriate paperwork for them (and potentially help answer any questions). You may also find yourself eligible for COBRA—a federal law allowing individuals who’ve lost their jobs through no fault of their own (including layoffs) and worked for an organization less than 18 months prior that provides group health coverage through an employer-sponsored plan (such as a PPO) continue receiving benefits from their former employer during specified periods after leaving employment
If you have a job that offers health insurance, you can choose to accept or decline. Official forms to choose this benefit should be sent out with your new hire, but if you don’t see one, talk to your HR representative about signing up for it.
If you have a job that offers health insurance, you can choose to accept or decline. Official forms to choose this benefit should be sent out with your new hire paperwork, but if you don’t see one, talk to your HR representative about signing up for it.
If you do sign up for the plan, it means that whenever there is an open enrollment period at your company (usually summer and winter), you can choose whether or not to renew their coverage in the next year. If there’s no open enrollment period but this is still an option for employees and/or spouses eligible under COBRA, contact Human Resources and ask them how much time there is until when COBRA will run out. If none of these apply and no one has contacted me yet… then maybe I don’t have health insurance yet?
2. Through COBRA
- Through COBRA
If you are laid off or lose your job, you may be eligible to continue your employer-sponsored health insurance for a limited amount of time through the Consolidated Omnibus Budget Reconciliation Act (COBRA). The law requires employers with 20 or more employees to offer their employees the option of continuing their employer-sponsored coverage for up to 18 months after they leave employment. Employees pay full price for this coverage, plus a 2% administrative fee paid by the employer. However, many times insurance companies will discount the cost of COBRA coverage so that no employee pays more than they would have paid in premiums if they had stayed with their previous plan (though this varies depending on which state you live in). If you’re eligible for COBRA and decide not to enroll in it, you may be responsible for paying penalties under Internal Revenue Code Section 5000A starting in 2020 – although these penalties will only affect those who were uninsured for two or more consecutive months during 2019; if this applies to you, then it’s worth exploring whether switching from one type of health insurance plan with another might save money overall and help avoid these penalties!
Most companies offer COBRA, which allows you to remain on your company’s plan for up to two years after you leave the company (or longer under some circumstances). The downside is that you’ll be paying 100% of the premium yourself; your employer will no longer be subsidizing some of the cost.
COBRA stands for the Consolidated Omnibus Budget Reconciliation Act of 1985, which was created to make it easier for people who lose their health insurance because they change jobs or leave a job.
COBRA allows you to remain on your company’s plan for up to two years after you leave the company (or longer under some circumstances). The downside is that you’ll be paying 100% of the premium yourself; your employer will no longer be subsidizing some of the cost. You can find out how much COBRA costs here: https://www.healthcare.gov/fees-and-insurance/recovering-costs/.
You should also know that if you’re eligible for Medicare, you can’t enroll in COBRA until three months before your 65th birthday (or six months if disabled). After that time passes, though, anyone on Medicare must buy an individual policy through an exchange instead of using their employer’s group plan—which may mean higher costs than what someone could get under COBRA would pay out during those three months before reaching 65 years old.
3. Through Medicare/Medicaid
- Through Medicare/Medicaid
If you qualify for Medicare or Medicaid, these government health insurance programs can provide you with coverage. However, there are many requirements regarding who qualifies for each program and how much they pay for such things as prescription drugs and doctor visits. These programs also have strict rules about eligibility and when an individual must apply for coverage. It’s important to understand how each program works before applying so that you can take advantage of any benefits provided by having health insurance through one of them
- If you think that either of these programs may be able to help cover medical expenses then it’s a good idea to apply as soon as possible so they can determine if they will offer any sort of coverage at all.*
These are government-run programs that provide insurance coverage for people who meet specific criteria such as getting SSDI or living below a certain income threshold. You can apply at any time and will receive a determination letter within several months of applying. The majority of applications are approved.
You can apply at any time, and you’ll receive a determination letter within several months of applying. The majority of applications are approved.
You can apply for Medicaid or CHIP if you meet the following criteria:
- You’re eligible for SSDI, SSI, or Social Security Income (SSI) benefits; or
- Your family income is below 138% of the federal poverty level; or
- You qualify for an exception to this rule based on your state’s own guidelines (for example, being pregnant).
4. From an individual provider
You should know that individual providers are more expensive, and you can’t be denied coverage for a pre-existing condition. However, you’ll have access to a wider range of plans with individual providers.
In addition to health insurance plans, deductible amounts (the portion of your bill you must pay before your insurance begins) and co-payments (fixed dollar amounts paid at the time of service) vary from provider to provider.
The Affordable Care Act requires all Americans to have health insurance, and while there is a penalty for not having it, many prefer to pay the penalty than to pay the full monthly premium on an individual market plan. These plans are usually more expensive than a group plan offered through an employer, but they are guaranteed issue (meaning they cannot deny you coverage if you have a pre-existing condition).
While the Affordable Care Act requires all Americans to have health insurance, and while there is a penalty for not having it, many prefer to pay the penalty than to pay the full monthly premium on an individual market plan. These plans are usually more expensive than a group plan offered through an employer, but they are guaranteed issue (meaning they cannot deny you coverage if you have a pre-existing condition).
While this can seem like a daunting task at first glance, don’t worry—there are plenty of options available for you! You can get health insurance through your employer or you can purchase individual plans in your state’s marketplace (the ACA created marketplaces in every state).
Health insurance can be confusing and complicated, but it’s important for everyone to understand how it works. If you have any questions about your coverage, contact me and I’ll be happy to help!