RICHMOND, Va -- When someone loses a job, experts say that newly unemployed person usually seeks financial help before figuring out their healthcare coverage.
An estimated 90,000 Virginians have lost health insurance because of job loss during the pandemic, and time is running out on the open enrollment period on the federal marketplace.
Those seeking health coverage plans in 2021 through healthcare.gov can enroll in plans offered in your area through Tuesday, December 15. After that, only those who experience specific life events can buy into plans.
Bart Benne and his wife were both laid off during the pandemic, but their 2020 started on a much higher note: they were married on leap day.
“When I got laid off, it wasn’t such a big hit to me, but just last month, she ended up getting laid off, so we ended up being put back into the marketplace,” Benne said.
Benne lives in North Carolina and his wife lives in Midlothian; they put off her move to the Tar Heel State because of the pandemic. Both brought dependent children to the marriage, so their geographical and family situation complicated their health insurance application process through healthcare.gov, according to Benne.
“It was such a confusing system, especially with our circumstances,” he said. “We’re savvy professionals; we know what we’re doing. She’s in IT, and I’m in marketing, so we know how to read things and get through it. But this was such a difficult process that it really required the help of a professional.”
After spending three hours on the phone with a navigator, someone trained to help people like Benne find the best option, his family was able to enroll in a plan. The headaches it took to get there were worth it, according to Benne.
“You have to have health coverage, especially during a pandemic,” he said. “The website for the Marketplace is inviting, it has a lot of information in there, but to make sure you’re really getting the best deal possible, make sure you reach out to the professionals.”
“It can be quite overwhelming,” said Sara Cariano, lead navigator at Enroll Virginia, a non-partisan organization that helps Virginians seeking medical coverage through the Marketplace and other avenues.
Cariano said some of the 90,000 Virginians who lost jobs and got health insurance through their employer qualify for COBRA, which gives workers who lose their health benefits the right to choose to continue on their group health plan for limited period of time. Still, she said after factoring subsides, plans on the Marketplace can be more affordable in some circumstances.
“Often, it can be less expensive than COBRA because COBRA is your employer plan that you are paying full costs for. So that’s often a really expensive option,” Cariano said. “We really encourage people to not just look at the premium cost but all these other factors that make health insurance really valuable for you and your family. Who’s in network, what prescriptions are covered, and what are your needs? We really help you drill down and figure out the best option for you.”
The sticker shock for many of the plans offered on healthcare.gov is a factor. A search of those offered to a single individual in Richmond begin with $300 premiums each month. Cariano said many workers qualify for subsides or even Medicaid, after the state expanded the income level for those who qualify the program back in 2019.
“The unsubsidized costs of the plans are pretty expensive. But 84% of people who enrolled last year through healthcare.gov got financial help paying for that coverage that brought the average premium down to $94 per month,” she said. “A family of four [making] up to $104k per year in income can still get some subsidies to purchase that coverage.”
“[Medicaid] is a month to month eligibility determination based on your income, so if you have a six month period where you’re looking for work, you may be monthly eligible for Medicaid and you know you’re protected,” Cariano said. “The nice thing is that a Marketplace application actually does a Marketplace and Medicaid assessment. You can do one application and figure our how much help you can get and where you can get it.”
Since open enrollment for 2021 plans on the Marketplace end in less than one week, both Cariano and Benne encouraged those who need coverage to seek help from a navigator immediately.
“An application lets you know what you’re eligible for, it doesn’t require you to purchase that. I always encourage folks just do it and know what your options are so you know you’re making the best decision for you and your family,” Cariano said.
“My real advice is start right now, start as soon as you can. You only have a week left and who knows what obstacles are going to come up with your own personal situation. Start today, and get professional help,” Benne said. “Don’t be intimidated. It is an involved process. There are professionals that are there to help you. It is something that’s really important for you to have.”
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