The Basics of Health Insurance Coverage During the COVID-19 Outbreak

By Paul McCoy, CIMA®, AIF®

As of May 8, 2020, the total number of confirmed COVID-19 cases reached 1.2 million in the United States.¹ In the face of a global health crisis, having access to health coverage is critical.

The COVID-19 pandemic has brought many shifts in the economy and business capacity, which has inevitably impacted the employment status of thousands of Americans. As a result, the health coverage status of many has also changed. Below we’re exploring how you can stay prepared when confronting the following four different coverage scenarios that may arise during COVID-19.

Scenario #1: You’ve Lost or Anticipate Losing Coverage

There is a yearly Open Enrollment Period to sign up for health insurance (for 2020, it was November 1, 2019 - December 19, 2019 for most states).² However, Special Enrollment periods are offered for individuals facing certain life events, such as loss of health coverage or having a baby. In light of a global health crisis, it is even more critical to have health insurance, and individuals who may have lost their health insurance — or need to make a change in their coverage — can take advantage of a Special Enrollment Period. Below is a summary of individuals that may be eligible:

Those who lost a job-based plan in the past 60 days
Those who are expected to lose coverage in the next 60 days, including those losing coverage through a parent or guardian because they will no longer be a dependent
Those who have been furloughed
Those who have COBRA continuation coverage after losing job-based coverage

Individuals who lost their jobs, but did not previously have health coverage because their jobs didn’t offer it, do not qualify for a Special Enrollment Period.³

Scenario #2: You Can’t Pay a Premium Due to a Hardship Related to COVID-19

If you are unable to meet a premium payment deadline, the U.S. Centers for Medicare & Medicaid Services recommends checking with your insurance company to extend the deadline or delay termination of your coverage. In most circumstances, there is a one-month grace period according to your state's law, and if you’re receiving financial assistance, there is a three-month grace period. However, if your income level has changed, you’re encouraged to updated your insurance application, as you could qualify for additional savings.³

Scenario #3: Your Child Moved Home or Has Recently Graduated

Your child may now be living with you after being sent home from their college due to COVID-19. He/she may also simply be home for the summer or is now returning home after graduating college. With the unemployment rate at 14.7 percent, recent graduates may have difficulty finding a job (and therefore, coverage by an employer).⁴

If your child was enrolled in a student health plan (or lived in a foreign country or U.S. territory for 60 days before their move home), he/she may qualify for a Special Enrollment Period and may be eligible to be covered under your plan. If your child is under 26 and you didn’t plan or don’t plan to claim them as a tax dependent, they can create a separate application through their own Marketplace account. However, if you claimed or plan to claim your child as a dependent, you can update your application to include your child.³

Scenario #4: You or Your Dependents Need to Be Tested for COVID-19

Many health insurance plans are waiving co-pays for testing related to COVID-19. Some are also waiving cost-sharing for treatment, while others are not. If you anticipate visiting your doctor with COVID-19 symptoms, check the details of your health insurance plan to better understand the potential costs involved. In addition, several providers are offering virtual or telehealth services as part of their plan.⁵

With six vaccines currently in clinical evaluation and around 70 in pre-clinical evaluation, the World Health Organization is maintaining a coordinated effort to curb the spread of COVID-19.⁶ Until then, however, taking steps to remain safe and understand the details of available healthcare resources remains critical.

This content is developed from sources believed to be providing accurate information, and provided by Twenty Over Ten. It may not be used for the purpose of avoiding any federal tax penalties. Please consult legal or tax professionals for specific information regarding your individual situation. The opinions expressed and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security.