People unemployed due to pandemic have health insurance options

Dealing with a pandemic is one thing, but losing your job and your health care in addition to a pandemic is another.

Geisinger professionals Terry Carpenter, director of state government programs, and John Columbo, individual sales supervisor for the Geisinger Health Plan, as well as Joe Bayura, UPMC director of product development and small group sales, have been helping those individuals who have lost their jobs and their health care insurance plans during the COVID-19 crisis.

According to Carpenter and Bayura, there is a 60-day window from when individuals lost their jobs and insurance to go “shopping” for a new plan through the Affordable Care Act, including a marketplace plan, the Children’s Health Insurance Program, Medicare or Medicaid.

The only factor individuals need to qualify is that the individual lost their job and job-based insurance during this time.

“It is important to be covered right now,” Carpenter said. “On top of the health crisis right now and the job market being up in the air. If you miss the 60-day window then you cannot get coverage unless you qualify for Medicaid, or you will have to wait until the open enrollment in November. That is a rule that has already existed, but with everything going on right now it becomes a concern because you won’t get coverage if the economy doesn’t bounce back right away.”

“Be proactive,” Bayura said. “You do not want the 60 days to expire.”

Medicaid, however, does not have a deadline by which you must apply, Carpenter said.

There are also different levels of coverage that individuals can get, these levels include different deductibles and different prices.

Those who are older than 65 years of age can review their Medicare Advantage options and look at different plans as well.

UPMC and Geisinger both have a variety of levels of insurance packages that individuals can buy from the marketplace inclduing: bronze, silver and gold level packages.

“Great news is when they go through the market place they apply through their income base,” Bayura said. “At UPMC they continue to offer the lowest cost options. Healthcare.gov will guide them in whatever direction.”

According to Bayura and Jeffrey Davis, UPMC public relations senior director, UPMC is the only carrier that offers insurance for every line of business including Medicaid, Medicare, CHIP, ACA exchange, and more.

Geisinger covers a gold level with a $0 deductible health plan, which includes prescriptions, dental vision and hearing and sometimes gym memberships with low monthly premiums according to Carpenter.

Carpenter also added that there are bronze and silver level insurance plans that have higher deductibles with higher out of pocket costs for visits but premiums will be lower.

He described the bronze plan as a 60/40 plan and the silver as a 70/30 plan.

“Children are automatically referred to CHIP,” Columbo said. “It is a pretty complete program and children always qualify.”

CHIP is a program designed specifically for children that provides the same care that Medicaid does. The program is for families with children who cannot afford insurance but may not be eligible for Medicaid.

Columbo also said that the program may include a deductible depending on the financial situation of the parents.

“The original intent of CHIP was medical assistance coverage for kids, but it has grown into other things,” he said. “If the child is in one of these programs, anything that is medically necessary is covered for the children.”

In terms of plans within the marketplace, some restrictions have been loosened while still maintaining similar coverage during this time according to Carpenter.

He also added that the application process is being moved through faster during this time for people who choose to apply for a plan within the marketplace as well.

“It (marketplace) can be very confusing,” Bayura said.

For anyone who needs help choosing a plan or navigating the marketplace, UPMC has operators that help individuals get the insurance plan that suits their needs. Individuals can call 1-877-563-0292 for help.

In addition, Individuals can also apply for a tax credit if eligible. More information on tax credits are available through healthcare.gov.

Coverage is available for businesses of all sizes, individuals and families, children, elderly and beyond according to a news release.


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