we understand this can be a scary time
with the economy disrupted by covid-19, some companies are downsizing. Many people are suddenly out of a job and without health insurance. We understand that the loss of health insurance can be frightening. When you live without insurance, even the most basic care can take a financial toll. therefore, one of the first things you should do at this point is to explore ways to obtain coverage. Here are eight options that might help you get health insurance during these tough times:
coverage through a spouse
If you’re married and your spouse has a coverage option through their job, it’s usually the cheapest option for your spouse to add you and your family to their plan. Or, if your spouse is not currently enrolled in the coverage option through their job, they could enroll and then add you and your family. But don’t delay, there’s a 30-day special enrollment period to make the switch. After that, you and your family won’t be able to join the plan until the standard open enrollment period at your spouse’s company. If you’re under 26, you may even be able to join your parent’s employer-based plan.
Look at the health insurance marketplace (or “exchange”)
The Health Insurance Marketplace (also known as the Exchange) is a service that helps you shop for and enroll in affordable health insurance. mass., r.i. and n.h. everyone has their own market options.
massachusetts offers health plans from leading insurers in the massachusetts health connector. In response to COVID-19, the Connector is offering an extended enrollment period through June 23, 2020 for qualified Massachusetts residents who are uninsured.
tufts health plan offers two high-quality health plans through the connector:
- tufts health direct: Our network plan focused on individuals and families. members can access affordable connectorcare plans and other financial assistance programs. For more information, visit Tufts Health Direct or call 888.257.1985.
- tufts health premier: Affordable hmo plans with a variety of benefit options. for more information, call 800.462.0224.
- tufts health together – (our masshealth plan). Members get all the benefits of MassHealth, including visits to doctors and specialists, children’s prescription drugs, eye exams and glasses. For more information, visit Tufts Health Together or call 888.257.1985.
- tufts health ritogether – (our r.i. medicaid plan). members get all the benefits of rhode island medicaid and more, including discounts, perks and health coaching. For more information, visit Tufts Health Ritogether or call 866.738.4116.
- tufts health unify – (our medicare-medicaid one care plan). Members get all of the benefits of MassHealth and Medicare, plus a care manager, personalized care plan, and long-term services and supports. For more information, visit Tufts Health Unify or call 855.393.3154.
- massachusetts has a “mini-cobra” law that provides continuation coverage if you worked for a small business with 2-19 employees. in most cases, you have 60 days to elect coverage.
- rhode island has an extended medical benefits statute. This means that even if you do not qualify for federal Cobra insurance, you may still be eligible for continuation coverage in Rhode Island.
- new hampshire: status continuation allows you to continue coverage if your group health plan is fully insured and you are a new hampshire resident. state continuation applies to employers of any size.
You can learn more about the connector here or by calling 877.623.6765.
rhode island offers health plans through healthsource ri, which offers a special enrollment period (september) through april 30, 2020 for qualified uninsured individuals. those who complete an online application must indicate that they have experienced an “other” September event and note the coronavirus as an explanation. coverage will begin the first day of the month following the request. For more information, contact the HealthSource RI Call Center Monday through Friday, 8 a.m. to 5 p.m. m. to 6 p.m. m. at 1-855-840-4774.
new hampshire offers the granite advantage health care program. Coverage for individuals with Granite Advantage is provided through the New Hampshire Medicaid Care Management (MCM) Program plans. The program is for adults ages 19 to 65 who are within certain income limits and need health coverage. you can enroll in the granite advantage program through nh easy.
buy an “off-exchange” plan
“Non-exchange” describes a health insurance plan you buy directly from an insurance company or through a licensed broker outside of an official state or federal health insurance marketplace (or exchange). All of these plans are “guaranteed issue,” meaning the insurance company can’t deny coverage because you have a pre-existing medical condition or because they expect you to use a lot of medical services.
For information on companies that offer plans to people in massachusetts, including tufts health plan, visit our partner agency, hsa insurance.
are you eligible for medicaid or masshealth?
Medicaid is a public assistance health program for low-income Americans, regardless of age. in massachusetts, the program is called masshealth. provides free or low-cost health coverage to individuals, families and children, pregnant women, the elderly, and people with disabilities. Many states have expanded their Medicaid programs to cover everyone below certain income levels. mass., r.i. and n.h. all offer expanded coverage for low-income adults.
tufts health plan offers three medicaid plans:
You can learn more about the Medicaid program here. For more information on Medicaid, visit MassHealth, HealthSource RI, or One Care.
opt for cobra
cobra (the Consolidated Omnibus Budget Reconciliation Act) can provide a good bridge until you find a new job with health insurance benefits. If you lose your job or experience a reduction in work hours, Cobra allows you to continue with your same group insurance plan for 18 months. no changes can be made to your plan during this time. however, those who lose their jobs because a business closes may not be eligible for cash if the business cancels their group insurance plan.
You have 60 days to enroll in cobra after your health insurance benefits end. however, cobra coverage can be expensive because your former employer may no longer pay a portion of your health insurance premium and you will be responsible for 100% of it, plus an administrative fee.
cobra is for companies with 20 or more employees. massachusetts, rhode island, and new hampshire also have their own state-backed coverage continuations:
explore chip for kids
Children’s Health Insurance Program (CHIP) provides low-cost health coverage to children in families who earn too much money to qualify for Medicaid. You can learn more about the chip and how to order it here.
community health centers can help
Community health centers, which provide care to people without health insurance, have sliding fee scales based on income. These centers can be found in many parts of the country and are regulated by the federal government. Many centers also offer counseling services to help people find low-cost health insurance or care.
You can find more information about the health centers here.
are you a veteran?
Eligible veterans can apply for health care benefits through the us. uu. department of veterans affairs. you can get more information here.
medicare may be an option
If you’re 65 or older and recently lost your job, signing up for a Medicare plan may be your most cost-effective option for health coverage, even compared to Cobra. our medicare experts can help you review your options and select the plan that best suits your needs. learn more about medicare insurance or call 1-800-890-6600 (tty: 711).
At Tufts Health Plan, we hope this information about health insurance options is helpful to you during these difficult times.