How to find health insurance after losing coverage
If you’ve lost your health insurance coverage, you have options no matter how long of a coverage gap you need to fill. Here’s what you need to know about federal programs and how to switch to an individual plan.
What to know about COBRA
Thanks to the Consolidated Omnibus Budget Reconciliation Act of 1985, or COBRA, you may be able to temporarily continue the same group coverage you had through your employer, but instead of sharing the cost, you’ll pay the full monthly amount. This federal law only applies in certain situations, such as after termination of employment, reduction in hours or a qualifying life event. Employers outside of the federal government who have more than 20 employees and who offer health insurance are required to provide COBRA coverage. COBRA does not apply if an employer is terminating coverage because they no longer have active employees or if their business is temporarily closing. In these scenarios, standard contract termination provisions apply.
Benefits of electing COBRA
If you’re eligible for COBRA, it may allow for a smooth transition without a gap in coverage or loss of cost-share that has been applied to the deductible and out-of-pocket maximum. Once you elect COBRA, you are no longer eligible for a Special Enrollment Period (SEP) to choose an individual plan until the annual Open Enrollment Period. This period runs from Nov. 1 through Jan. 15, and plans begin on Jan. 1 or when your COBRA coverage ends.
What to know about switching to individual coverage
If you lose group coverage because of job loss, you qualify for a Special Enrollment Period and have the option of purchasing an individual policy.
Choosing coverage from Sanford Health Plan
You can enroll in an individual plan directly from Sanford Health Plan. You’ll have flexible effective date options and, due to COVID-19, we’re waiving the requirement for proof of employer coverage loss for current members.
Choosing coverage through the federal Marketplace
You also have the option to enroll in an individual plan through the federal Health Insurance Marketplace at healthcare.gov. If you qualify for financial assistance, this is a great option to help lower your monthly premiums and out-of-pocket costs. Although loss of employer-sponsored coverage qualifies for a Special Enrollment Period on the Marketplace, documentation proving loss of employer sponsored coverage is required.
By choosing an individual policy, you may experience cost savings depending on your individual household situation.
If you’re between jobs, facing layoff or considering early retirement, Sanford SAFEGUARD may be able to provide the gap coverage you need right now. Sanford SAFEGUARD short-term health insurance can provide you with coverage over a three or six-month timeframe – without the extra cost and features of a more traditional extended plan, as long as you’re in good health today. With plans starting at $58* per month, our short-term coverage includes doctor visits, urgent care benefits, discounts on dental, vision and hearing services, emergency room and ambulance coverage, and $0 virtual care 24/7.
Important to note: Short-term plans such as Sanford SAFEGUARD do not cover pre-existing conditions. In addition, this coverage is not required to comply with certain federal market requirements for health insurance, such as those contained in the Affordable Care Act.
*57.81 is an example rate for a two to 19 year old on a three-month policy.