Loss of health insurance

​Verify the license of a health insurance agent online.​​

During times of disaster and economic uncertainty, it is common for people to receive calls from someone selling health insurance plans that do not provide important consumer protections, including protections for people with pre-existing conditions. Seeking assistance from local licensed agents will help reduce the risks of purchasing products not suitable for your needs.​​​

​ There are a number of different options depending on your circumstances. Those may include the following:

• Marketplace coverage through oregon.healthcare.gov
• Oregon Health Plan
• COBRA
• State continuation
• Medicare
• Employer based coverage from your previous employer or through a spouse’s insurance.​
  

​COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) is a federal law that requires businesses of at least 20 employees to continue any health benefit coverage for people who would otherwise lose coverage due to termination of employment, reduction in hours, or certain other events. Once enrolled in COBRA, you cannot cancel mid-year and enroll in a plan through the Marketplace without another qualifying event.

COBRA allows you and your family to keep the same employer-based health insurance for up to 18 or 36 months, but you must pay the entire cost of the premium. Your employer must contact you with information about COBRA coverage. At that point, you have 60 days to decide on purchasing the coverage. COBRA is only available if your employer is still offering coverage to its existing employees.

​COBRA coverage on HealthCare.gov

​​State continuation applies to people who have had continuous health coverage (not necessarily with the same employer) for at least three months, before the date employment or coverage ended. State continuation enables​ you and your family to continue on the same employer-based health insurance for up to nine months, but you must pay the entire cost of the premium.

To continue coverage, you must notify the insurance company in writing within 10 days after the date you become eligible, or 10 days after the insurance company notifies you of eligibility.

You have to pay the full price of the coverage, and your employer can tell you the cost of the insurance, the date your payment is due, and how you must pay.

Once enrolled in state continuation, you cannot cancel mid-year and enroll in a plan through the Marketplace without another qualifying event.

State continuation is available only if your employer is still offering coverage to its existing employees.

​

​Oregon Health Plan (OHP) is free coverage for eligible people and families. It is Oregon’s Medicaid program.

The Oregon Health Plan provides physical, dental, and mental health care for households with lower incomes. You can apply for OHP at any time. Enrollment is always open. It takes time for the application to process, but coverage will be retroactive to the date of application, if you qualify.

You can have OHP even if you still have a job. Eligibility is based on current monthly income and varies by household size and other circumstances. Household income is calculated from all taxable income sources, including any unemployment insurance benefits. See the table below for income examples.

​ohp.oregon.gov.

​The loss of employer-sponsored health coverage (e.g., from a job loss) triggers a special enrollment period that allows you get a private health plan and a subsidy through the Oregon Health Insurance Marketplace and HealthCare.gov. You have up to 60 days after the date the coverage is lost to get a health plan at HealthCare.gov. If you sign up before losing your employer-based coverage, you can secure Marketplace coverage that begins the next month and avoid a gap in coverage.

• Details : You may be eligible for federal subsidies for insurance purchased on the Marketplace if your expected household income for 2020 is less than four times the federal poverty level. This is about $50,000 a year for a single person or about $103,000 a year for a family of four. In many cases, the children in these families are eligible for coverage through the Oregon Health Plan. Open enrollment for anyone to purchase insurance on the Marketplace is usually in November and December.

Oregon Health Insurance Marketplace​

​Medicare is for U.S. citizens 65 and older who meet residency requirements and some blind and disabled people younger than 65. Workers 65 years old or older who lose their employer-based insurance can immediately enroll in Medicare with no penalty.

Medicare.gov​

The Oregon Senior Health Insurance Benefits Assistance (SHIBA) program provides free Medicare information and enrollment assistance at ​SHIBA.Oregon.gov or call 800-722-4134.​​​​

If you remain on your same coverage, your health insurance would continue with the same deductibles and co-pays as before. However, if you have a reduction in hours, your premiums, co-pays, and coverage may change.

A reduction in income and an increase in monthly premiums may make you eligible for federal subsidies for individual insurance coverage through the Marketplace. Check your eligibility by going to HealthCare.gov​.

If you lose your employer-based coverage, you may be able to obtain coverage through your spouse or domestic partner’s employer-based coverage. Employee-paid premiums and other cost-sharing will vary, depending on the rules of your partner’s employer. Check with your partner’s employer for more information.