The unprecedented coronavirus pandemic is wreaking havoc across the globe. As this health scare progresses, countries are doing their best to slow or stop this aggressive pandemic—many have issued shut-downs and travel bans. In early March, the United States issued travel restrictions and social distancing guidelines to help flatten the curve and lower the looming predicted death rate. This was shortly followed by individual states issuing stay-at-home orders, and limiting outings for essential needs and workers.
As these safety measures are progressively fighting the pandemic, COVID-19 is also impacting many businesses and lives financially. Many have been deemed non-essential and have had to close their doors and many employees have lost their jobs or hours during this time.
Whether you have lost your health coverage due to these trying times or aren’t insured but now worried due to the pandemic, there may be some options for you. You may qualify for a special enrollment period or live in a state that has opened a special enrollment period for the uninsured and can now enroll in Affordable Care Act (ACA)-compliant coverage, or if neither of those apply to you, you may be able to enroll in an ACA-alternative health plan like short-term medical.
Experiencing a sudden loss in health coverage?
If you lose your health coverage through moving to a different state or through the loss of a job, you become eligible for a special enrollment period . A special enrollment period allows you to enroll in an ACA-compliant plan if you have a qualifying life event. Typically, coverage is only available during the November 1 – December 15 annual open enrollment period. However , as long as you have a qualifying life event, you are allowed to sign up for coverage outside of that window.
If you experience a qualifying life event, you typically have 60 days to select a plan. Some qualifying life events include:
- Birth or adoption of a child
- Marriage or divorce
- A permanent move to an location outside of your current plan’s coverage area
- Loss of job with minimum essential health coverage
There are more qualifying life events not mentioned. To speak to a licensed agent to see if you have a qualifying life event and to learn about your options call 855-548-0727 or visit VelaPoint Marketplace for more information.
Some States Open Special Enrollment Periods to enroll uninsured
Many state-based exchanges have opened special enrollment periods triggered by the coronavirus pandemic. To help our nation fight the virus and allow more Americans access to health coverage during the COVID-19 pandemic, these state-based exchanges are now open for ACA-compliant plan enrollment.
|State||Enroll by Date|
|Washington State||April 8|
|Rhode Island||April 15|
|New York||April 15|
As of March 31, the white house administration has not opened the federal exchange for enrollments which include 38 states. As news and updates on COVID-19 continue to occur daily, we will keep you posted on any updates related to the federal exchange.
Not eligible for ACA-compliant coverage? Other Options Available
Even with the options above, many will not have access to a special enrolment period. Examples include if they live in a State using the federal exchange and don’t have a qualifying life event, if they lost their job but didn’t have employer or aca-compliant coverage, or if they are ineligible for ACA marketplace subsidies and find the full cost of coverage unaffordable. For these individuals facing this time without coverage, short-term medical plans may be an option.
Short-term medical plans can be enrolled in anytime throughout the year, however, many plans offer limited benefits and may exclude coverage for pre-existing conditions. Short-term medical insurance offers a range of flexible and customizable coverage options including varying benefit levels, deductibles, and duration of plan lengths. Designed to cover individuals for a pre-determined length of time, these periods can range from a few months up to a year depending on your state of residence. Consult with a licensed agent to find out whether short term medical plans are available in your area.
Full coverage of COVID-19 testing by federal law mandate
On March 17, The Families First Coronavirus Response Act (H.R.6201) was signed into law and requires nearly all health plans (including Medicare and Medicaid) to pay for COVID-19 testing. This includes the lab fees and fees associated with the doctor’s office, urgent care clinic or emergency room where the test is administered. Health plans cannot impose any cost sharing or prior authorization requirements for Covid-19 testing throughout the duration of the COVID-19 emergency period.
This mandate doesn’t apply to short-term health plans or other plans that aren’t considered minimum essential coverage; however, many states are implementing their own requirements that may include short-term medical plans. Also, some insurers have voluntarily taken steps to reduce or eliminate cost sharing related to COVID-19, most are focusing on testing, but some may include treatment. UnitedHealthcare, Cigna and National General Insurance have made COVID-19 announcements to this affect.
The COVID-19 pandemic is an uncharted territory for the United States, our lives have changed dramatically as the fight against the virus continues. It is important to make sure you know your resources and stay up-to-date on ways you can keep safe during this time. Even with all this helpful information, it can still be a lot to take in. Our licensed agents can help explain further and walk you through a needs-analysis to help determine where your coverage needs land. Call 855-548-0727 or visit VelaPoint Marketplace for more information.
Healthinsurance.org, www.kff.org, healthcare.gov, www.cdc.gov\
ACA = Short for the “Affordable Care Act.” ACA health insurance plans meet the minimum essential coverage requirements and cover pre-existing conditions as well as the 10 essential health benefits (e.g. maternity care, mental health, preventative care, prescription drugs, and more). ACA plans also offer subsidies and premium tax credits to eligible individuals based on income. These subsidies and credits are designed to lower your ACA plan’s monthly premium. Individuals may only enroll in ACA coverage during the annual Open Enrollment Period (November 1st – December 15th) unless they have a Qualifying Life Event. Visit Healthcare.gov for more information.
Short Term Medical (STM) and other ACA-alternative plans are medically underwritten and are not required to meet the minimum essential coverage requirements or provide the 10 essential health benefits as mandated by the ACA. This means that non-ACA plans may not cover certain types of services, including but not limited to: maternity care, mental health, preventative care, and prescription drugs. Non-ACA plans are also not required to cover pre-existing conditions. STM plans vary per state. Consult with a licensed agent for details.