With unprecedented unemployment during this public health and economic crisis — including South Carolinians who filed 415,635 new unemployment claims between March 7th and April 25th — an estimated 375,000 will lose their job-based health insurance by June. Palmetto Project’s Insure SC team can help these people secure comprehensive and affordable coverage, but they must act quickly.
Individuals who lose their job-based coverage qualify for a Special Enrollment Period (SEP) on the Health Insurance Marketplace. This opens up a 60-day window to enroll in coverage, often with financial assistance that reduces monthly costs. If someone misses their chance to enroll, they may be unable to enroll in coverage until November 1, 2020, for coverage beginning in 2021.
“As unemployment numbers in recent weeks dwarf the worst weeks of the Great Recession, thousands of South Carolinians are losing the job-based insurance they rely upon to get access to quality health care,” said Shelli Quenga, Palmetto Project’s Director of Programs and a licensed insurance agent. “There are comprehensive and affordable coverage options that these workers can enroll in, but they must act quickly.”
Employees may be given the option to extend their job-based coverage by enrolling in COBRA, but employers often don’t contribute to the cost of the plan so the individual pays full price. This can make COBRA cost-prohibitive, with an average monthly premium of about $640 for a single individual, and $1,840 a month for a family of four for a typical employer plan. Plans sold in the Health Insurance Marketplace are likely to be significantly more affordable due to the financial assistance available, which 90 percent of SC’s marketplace enrollees qualify for. After financial assistance, the average monthly premium is $79 in SC.
Individuals who didn’t have insurance through their employer and are currently uninsured may still be able to enroll in coverage if they experience a life event that qualifies them for an SEP, such as getting married or having a baby. People can contact Palmetto Project’s team of local experts at 843-577-4122 to find out if they might qualify for an SEP. People who’ve lost their jobs or seen their incomes drop can also learn whether they qualify for free or low-cost comprehensive coverage through SC Healthy Connections Medicaid, which is often the best coverage for children.
Consumers enrolling in a Marketplace plan are guaranteed to receive comprehensive coverage, with no pre-existing condition exclusions or markups. These plans are required to cover essential health benefits (such as prescription drugs, lab services, hospitalization). Testing and treatment of COVID-19 are considered essential health benefits and are covered by all ACA plans, and testing is covered with no cost sharing.
Consumers should avoid insurance plans offered outside of the Marketplace that seem too good to be true. Unfortunately, a bevy of “junk insurance” products are available due to loosened regulations, and they pose huge financial risks to consumers. These products aren’t required to comply with ACA regulations, which means they can deny coverage to consumers with pre-existing conditions, charge consumers more based on their gender, reject claims altogether for health care services related to a pre-existing condition, and impose annual coverage limits. Many won’t cover the COVID-19-related services people need.
The health insurance landscape can be confusing, but free, local in-person help is available. Call Palmetto Project to talk with an expert who can help you navigate the enrollment process by visiting www.Insure-SC.org or calling 843-577-4122.